#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

A general view of epidemiology of hypoglycemia in type 1 and type 2 diabetes mellitus


Authors: Jan Brož 1;  Jana Urbanová 2
Authors‘ workplace: Interní klinika 2. LF UK a FN Motol, Praha 1;  Centrum pro výzkum diabetu, metabolismu a výživy, II. interní klinika 3. LF UK a FN Královské Vinohrady, Praha 2
Published in: Vnitř Lék 2019; 65(4): 289-294
Category:

Overview

Hypoglycemia particularly severe one is important side effect of diabetes therapy with impact on patient´s quality of life and mortality. The highest risk of hypoglycemia is connected with insulin therapy followed by derivates of sulfonylurea (SU) and glinides. The risk of hypoglycemia found in observational studies were 2–3 times higher in patients treated with SU and 3–4 higher when treated with insulin compared with other types of antidiabetics. The risk of hypoglycemia is increased in patients over 75 years of age, with longer period of treatment with insulin and in those treated with several types of antidiabetics.

Keywords:

Epidemiology – hypoglycemia – type 1 diabetes – type 2 diabetes


Sources
  1. Rahbar S. An abnormal hemoglobin in red cells of diabetics. Clin Chim Acta 1968; 22(2): 296–298.

  2. Goldstein DE. Is glycosylated hemoglobin clinically useful? N Engl J Med 1984; 310(6): 384–385.

  3. Nathan DM, Singer DE, Hurxthal K et al. The clinical information value of the glycosylated hemoglobin assay. N Engl J Med 1984; 310(6): 341–346.

  4. Nathan DM, Genuth S, Lachin J et al. [Diabetes Control and Complications Trial Research Group]. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulindependent diabetes mellitus. N Engl J Med 1993; 329(14): 977–986. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJM199309303291401>.

  5. [UK Prospective Diabetes Study (UKPDS) group]. Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998; 352(9131): 837–853. Erratum in Lancet 1999; 354(9178): 602.

  6. [International Hypoglycaemia Study Group]. Glucose Concentrations of Less Than 3.0 mmol/L (54 mg/dL) Should Be Reported in Clinical Trials: A Joint Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2017; 40(1): 155–157. Dostupné z DOI: <http://dx.doi.org/10.2337/dc16–2215>.

  7. Pramming S, Thorsteinsson B, Bendtson I et al. Symptomatic hypoglycaemia in 411 type 1 diabetic patients. Diabet Med 1991; 8(3): 217–222.

  8. Akram K, Pedersen-Bjergaard U, Carstensen B et al. Frequency and risk factors of severe hypoglycaemia in insulin-treated type 2 diabetes: a cross-sectional survey. Diabet Med 2006; 23(7): 750–756. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1464–5491.2006.01880.x>.

  9. Epidemiology of severe hypoglycemia in the Diabetes Control and Complications Trial. The DCCT Research Group. Am J Med 1991; 90(4): 450–459.

  10. Hypoglycemia in the Diabetes Control and Complications Trial. The Diabetes Control and Complications Trial Research Group. Diabetes 1997; 46(2): 271–286.

  11. Frier BM. Hypoglycaemia in diabetes mellitus: epidemiology and clinical implications. Nat Rev Endocrinol 2014; 10(12): 711–722. Dostupné z DOI: <http://dx.doi.org/10.1038/nrendo.2014.170>.

  12. ter Braak EW, Appelman AM, van de Laak M et al. Clinical characteristics of type 1 diabetic patients with and without severe hypoglycemia. Diabetes Care 2000; 23(10): 1467–1471.

  13. Pedersen-Bjergaard U, Pramming S, Heller SR et al. Severe hypoglycaemia in 1,076 adult patients with type 1 diabetes: influence of risk markers and selection. Diabetes Metab Res Rev 2004; 20(6): 479–486. Dostupné z DOI: <http://dx.doi.org/10.1002/dmrr.482>.

  14. Pedersen-Bjergaard U, Agerholm-Larsen B, Pramming S et al. Prediction of severe hypoglycaemia by angiotensin-converting enzyme activity and genotype in type 1 diabetes. Diabetologia 2003; 46(1): 89–96. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–002–0969–4>.

  15. [UK Hypoglycaemia Study Group]. Risk of hypoglycaemia in types 1 and 2 diabetes: effects of treatment modalities and their duration. Diabetologia 2007; 50(6): 1140–1147. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–007–0599-y>.

  16. Gururaj Setty S, Crasto W, Jarvis J et al. New insulins and newer insulin regimens: a review of their role in improving glycaemic control in patients with diabetes. Postgrad Med J 2016; 92(1085): 152–164. Dostupné z DOI: <http://dx.doi.org/10.1136/postgradmedj-2015–133716>.

  17. Singh SR, Ahmad F, Lal A et al. Efficacy and safety of insulin analogues for the management of diabetes mellitus: a meta-analysis. CMAJ 2009; 180(4): 385–397. Dostupné z DOI: <http://dx.doi.org/10.1503/cmaj.081041>.

  18. Mullins P, Sharplin P, Yki-Jarvinen H et al. Negative binomial meta-regression analysis of combined glycosylated hemoglobin and hypoglycemia outcomes across eleven Phase III and IV studies of insulin glargine compared with neutral protamine Hagedorn insulin in type 1 and type 2 diabetes mellitus. Clin Ther 2007; 29(8): 1607–1619. Dostupné z DOI: <http://dx.doi.org/10.1016/j.clinthera.2007.08.020>.

  19. Vague P, Selam JL, Skeie S et al. Insulin detemir is associated with more predictable glycemic control and reduced risk of hypoglycemia than NPH insulin in patients with type 1 diabetes on a basal-bolus regimen with premeal insulin aspart. Diabetes Care 2003; 26(3): 590–596.

  20. Choudhary P, Amiel S. Hypoglycaemia in type 1 diabetes: technological treatments, their limitations and the place of psychology. Diabetologia 2018; 61(4): 761–769. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–018–4566–6>.

  21. Yeh HC, Brown TT, Maruthur N et al. Comparative effectiveness and safety of methods of insulin delivery and glucose monitoring for diabetes mellitus: a systematic review and metaanalysis. Ann Intern Med 2012; 157(5): 336–347. Dostupné z DOI: <http://dx.doi.org/10.7326/0003–4819–157–5-201209040–00508>.

  22. Beato-Vibora P, Yeoh E, Rogers H et al. Sustained benefit of continuous subcutaneous insulin infusion on glycaemic control and hypoglycaemia in adults with type 1 diabetes. Diabet Med 2015; 32(11): 1453–1459. Dostupné z DOI: <http://dx.doi.org/10.1111/dme.12869>.

  23. Quiros C, Gimenez M, Rios P et al. Long-term outcome of insulin pump therapy: reduction of hypoglycaemia and impact on glycaemic control. Diabet Med 2016; 33(10):1422–1426. Dostupné z DOI: <http://dx.doi.org/10.1111/dme.13094>.

  24. [REPOSE Study Group]. Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE). BMJ 2017; 356: j1285. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.j1285>.

  25. Bergenstal RM, Klonoff DC, Garg SK et al. Threshold-based insulin-pump interruption for reduction of hypoglycemia. N Engl J Med 2013; 369(3): 224–232. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1303576>.

  26. Weiss R, Garg SK, Bode BW et al. Hypoglycemia Reduction and Changes in Hemoglobin A1c in the ASPIRE In-Home Study. Diabetes Technol Ther 2015; 17(8): 542–547. Dostupné z DOI: <http://dx.doi.org/10.1089/dia.2014.0306>.

  27. Ly TT, Nicholas JA, Retterath A et al. Effect of sensor-augmented insulin pump therapy and automated insulin suspension vs standard insulin pump therapy on hypoglycemia in patients with type 1 diabetes: a randomized clinical trial. JAMA 2013; 310(12): 1240–1247. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2013.277818>.

  28. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998; 352(9131): 854–865. Erratum in Lancet 1998; 352(9139): 1558.

  29. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998; 352(9131): 837–853. Erratum in Lancet 1999; 354(9178): 602.

  30. Wright AD, Cull CA, Macleod KM et al. Hypoglycemia in type 2 diabetic patients randomized to and maintained on monotherapy with diet, sulfonylurea, metformin, or insulin for 6 years from diagnosis: UKPDS73. J Diabetes Complicat 2006; 20(6): 395–401. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jdiacomp.2005.08.010>.

  31. Gerstein HC, Miller ME, Byington RP et al. [ACCORD – Action to Control Cardiovascular Risk in Diabetes Study]. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 2008; 358(24): 2545–2559. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa0802743>.

  32. Aroup AC, Patel A, MacMahon S et al. [ADVANCE Collaborative Group]. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med 2008; 358(24): 2560–2572. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa0802987>.

  33. Duckworth W, Abraira C, Moritz T et al. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med 2009; 360(2): 129–139. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa0808431>. Erratum in N Engl J Med 2009; 361(10): 1028. Veterans Affairs diabetes trial--corrections. [N Engl J Med. 2009].

  34. Zoungas S, Patel A, Chalmers J et al. Severe hypoglycemia and risks of vascular events and death. N Engl J Med 2010; 363(15): 1410–1418. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1003795>.

  35. Bonds DE, Miller ME, Bergenstal RM et al. The association between symptomatic, severe hypoglycaemia and mortality in type 2 diabetes: retrospective epidemiological analysis of the ACCORD study. BMJ 2010; 340: b4909. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.b4909>.

  36. Silbert R, Salcido-Montenegro A, Rodriguez-Gutierrez R et al. Hypoglycemia Among Patients with Type 2 Diabetes: Epidemiology, Risk Factors, and Prevention Strategies. Curr Diab Rep 2018; 18(8): 53. Dostupné z DOI: <http://dx.doi.org/10.1007/s11892–018–1018–0>.

  37. Zinman B, Wanner C, Lachin JM et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 2015; 373(22): 2117–2128. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1504720>.

  38. Marso SP, Daniels GH, Brown-Frandsen K et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2016; 375(4): 311–322. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1603827>.

  39. Scirica BM, Bhatt DL, Braunwald E et al. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. N Engl J Med 2013; 369(14): 1317–1326. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1307684>.

  40. White WB, Cannon CP, Heller SR et al. Alogliptin after acute coronary syndrome in patients with type 2 diabetes. N Engl J Med 2013; 369(14): 1327–1335. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1305889>.

  41. Green JB, Bethel MA, Armstrong PW et al. Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes. N Engl J Med 2015; 373(3): 232–242. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1501352>. Erratum in Effect of Sitagliptin on Cardiovascular Outcomes in Type 2 Diabetes. [N Engl J Med. 2015].

  42. Zinman B, Wanner C, Lachin JM et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 2015; 373(22): 2117–2128. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1504720>.

  43. Marso SP, Bain SC, Consoli A et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2016; 375(19): 1834–1844. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1607141>.

  44. Neal B, Perkovic V, Mahaffey KW et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med 2017; 377(7): 644–657. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1611925>.

  45. Elliott L, Fidler C, Ditchfield A et al. Hypoglycemia event rates: a comparison between real-world data and randomized controlled trial populations in insulin-treated diabetes. Diabetes Ther 2016; 7(1): 45–60. Dostupné z DOI: <http://dx.doi.org/10.1007/s13300–016–0157-z>.

  46. Quilliam BJ, Simeone JC, Ozbay AB. Risk factors for hypoglycemia-related hospitalization in patients with type 2 diabetes: a nested case-control study. Clin Ther 2011; 33(11): 1781–1791. Dostupné z DOI: <http://dx.doi.org/10.1016/j.clinthera.2011.09.020>.

  47. Misra-Hebert AD, Pantalone KM, Ji X et al. Patient characteristics associated with severe hypoglycemia in a type 2 diabetes cohort in a large, integrated health care system from 2006 to 2015. Diabetes Care 2018; 41(6): 1164–1171. Dostupné z DOI: <http://dx.doi.org/10.2337/dc17–1834>.

  48. Davis TM, Brown SG, Jacobs IG et al. Determinants of severe hypoglycemia complicating type 2 diabetes: the Fremantle Diabetes Study. J Clin Endocrinol Metab 2010; 95(5): 2240–2247. Dostupné z DOI: <http://dx.doi.org/10.1210/jc.2009–2828>.

  49. [ORIGIN Trial Investigators]. Predictors of nonsevere and severe hypoglycemia during glucose-lowering treatment with insulin glargine or standard drugs in the ORIGIN trial. Diabetes Care 2015; 38(1): 22–28. Dostupné z DOI: <http://dx.doi.org/10.2337/dc14–1329>.

  50. Rosenstock J, Dailey G, Massi-Benedetti M et al. Reduced hypoglycaemia risk with insulin glargine: a meta-analysis comparing insulin glargine with human NPH insulin in type 2 diabetes. Diabetes Care 2005; 28(4): 950–955.

  51. Horvath K, Jeitler K, Berghold A et al. Long-acting insulin analogues versus NPH insulin (human isophane insulin) for type 2 diabetes mellitus. Cochrane Database Syst Rev 2007; (2): CD 005613. Dostupné z DOI: <http://dx.doi.org/10.1002/14651858.CD005613.pub3>.

  52. Monami M, Marchionni N, Mannucci E. Long-acting insulin analogues versus NPH human insulin in type 2 diabetes. A meta-analysis. Diabetes Res Clin Pract 2008; 81(2): 184–189. Dostupné z DOI: <http://dx.doi.org/10.1016/j.diabres.2008.04.007>.

  53. Roussel R, Ritzel R, Boëlle-Le Corfec E et al. Clinical perspectives from the BEGIN and EDITION programmes: Trial-level meta-analyses outcomes with either degludec or glargine 300 U/ml vs glargine 100 U/ml in T2DM. Diabetes Metab 2018; 44(5): 402–409. Dostupné z DOI: <http://dx.doi.org/10.1016/j.diabet.2018.02.002>.

  54. Zinman B, Philis-Tsimikas A, Cariou B et al. Insulin degludec versus insulin glargine in insulin-naive patients with type 2 diabetes: a 1-year, randomized, treat-to-target trial (BEGIN Once Long). Diabetes Care 2012; 35(12): 2464–2471. Dostupné z DOI: <http://dx.doi.org/10.2337/dc12–1205>.

  55. Ritzel R, Roussel R, Giaccari A et al. Better glycaemic control and less hypoglycaemia with insulin glargine 300 U/mL vs glargine 100 U/mL: 1-year patient-level meta-analysis of the EDITION clinical studies in people with type 2 diabetes. Diabetes Obes Metab 2018; 20(3): 541–548. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.13105>.

  56. Ritzel R, Roussel R, Bolli GB et al. Patient-level meta-analysis of the EDITION 1, 2 and 3 studies: glycaemic control and hypoglycaemia with new insulin glargine 300 U/ml versus glargine 100 U/ml in people with type 2 diabetes. Diabetes Obes Metab 2015; 17(9): 859–867. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.12485>.

  57. Mauricio D, Hramiak I. Second-Generation Insulin Analogues – a Review of Recent Real-World Data and Forthcoming Head-to-Head Comparisons. Eur Endocrinol 2018; 14(Suppl 1): 2–9. Dostupné z DOI: <http://dx.doi.org/10.17925/EE.2018.14supp1.2>.

  58. McCoy RG, Lipska KJ, Yao X et al. Intensive treatment and severe hypoglycemia among adults with type 2 diabetes mellitus: a population-based study. JAMA Intern Med 2016; 176(7): 969–978. Dostupné z DOI: <http://dx.doi.org/10.1001/jamainternmed.2016.2275>.

  59. Lipska KJ, Warton EM, Huang ES et al. HbA1c and risk of severe hypoglycemia in type 2 diabetes: the Diabetes and Aging Study. Diabetes Care 2013; 36(11): 3535–3542. Dostupné z DOI: <http://dx.doi.org/10.2337/dc13–0610>.

Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 4

2019 Issue 4

Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#