Severe hypoglycaemia is a major predictor of incident diabetic retinopathy in Japanese patients with type 2 diabetes
| Autor: | Tatsumi Moriya, Sachiko Tanaka-Mizuno, Hirohito Sone, Hidetoshi Yamashita, Shiro Tanaka, Shun Ishibashi, Yasuo Akanuma, Yasuo Ohashi, Shigehiro Katayama, Satoshi Matsunaga, Ryo Kawasaki, Satoshi Iimuro |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty endocrine system diseases Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Type 2 diabetes Hypoglycemia 03 medical and health sciences 0302 clinical medicine Endocrinology Japan Risk Factors Diabetes mellitus Internal Medicine medicine Humans Hypoglycemic Agents 030212 general & internal medicine Longitudinal Studies Aged Diabetic Retinopathy business.industry Incidence (epidemiology) Incidence Hazard ratio nutritional and metabolic diseases General Medicine Diabetic retinopathy Middle Aged medicine.disease Diabetes Mellitus Type 2 Female business Complication Retinopathy |
| Zdroj: | Diabetesmetabolism. 43(5) |
| ISSN: | 1878-1780 |
| Popis: | Hypoglycaemia is a common complication in diabetes patients. However, its relationship with retinopathy has not been well documented in patients with type 2 diabetes (T2D). This study aimed to investigate the associations between hypoglycaemia and the incidence and progression of diabetic retinopathy (DR).In this longitudinal cohort study, which was part of the Japan Diabetes Complications Study (JDCS), adult patients with T2D were recruited at 59 diabetes clinics across Japan. Their history of hypoglycaemia was assessed by standardized self-reported questionnaires. Severe hypoglycaemia was defined as having at least one episode with coma requiring an outpatients visit or hospitalization. Adjusted hazard ratios (HRs) for incidence and progression of DR over 8 years of follow-up were determined.Of 1221 patients without DR, 127 (10.4%) had experienced non-severe hypoglycaemia within the previous year, whereas 10 (0.8%) reported severe hypoglycaemia episodes. During the 8-year follow-up involving 8492 person-years, 329 patients developed DR. In 410 patients with prevalent DR, the adjusted HRs for incident DR were 4.35 (95% CI: 1.98-9.56; P0.01) and, for progression of DR, 2.29 (95% CI: 0.45-11.78; P=0.32) with severe hypoglycaemia.Having a history of severe hypoglycaemia was one of the strongest predictors of incident DR in patients with T2D, with a fourfold increased risk. Identifying patients with greater risks of DR based on their history of hypoglycaemia may help to personalize risk evaluation in patients with diabetes. |
| Databáze: | OpenAIRE |
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