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Severe hypoglycaemia in 1076 adult patients with type 1 diabetes: influence of risk markers and selection

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Pedersen-Bjergaard, Ulrik ; Pramming, Stig ; Heller, Simon R ; Wallace, Tara M ; Rasmussen, Ase K ; Jørgensen, Hanne V ; Matthews, David R ; Hougaard, Philip ; Thorsteinsson, Birger. / Severe hypoglycaemia in 1076 adult patients with type 1 diabetes : influence of risk markers and selection. In: Diabetes - Metabolism: Research and Reviews (Print Edition). 2004 ; Vol. 20, No. 6. pp. 479-86.

Bibtex

@article{b4f0ec9ab1f44a04b82e00497fd61ea9,
title = "Severe hypoglycaemia in 1076 adult patients with type 1 diabetes: influence of risk markers and selection",
abstract = "BACKGROUND: Differences between studies in rates of severe hypoglycaemia in type 1 diabetic cohorts are common and poorly understood. The purpose of this study was to assess the frequency of severe hypoglycaemia in unselected patients treated in different secondary care centres and to evaluate the influence of risk markers, clinical setting and selection.METHODS: Cross-sectional Danish-British multicentre survey of 1076 consecutive adult patients with clinical type 1 diabetes who completed a detailed questionnaire on hypoglycaemia and related issues. Key variable was the self-reported rate of severe hypoglycaemia during the preceding year.RESULTS: The overall rate of severe hypoglycaemia in the preceding year was 1.3 episodes/patient-year and episodes were reported by 36.7% of subjects. The distribution was highly skewed with 5% of subjects accounting for 54% of all episodes. There were no significant differences between countries or centres. Reduced hypoglycaemia awareness, peripheral neuropathy and smoking were the only significant risk markers of severe hypoglycaemia in a stepwise multivariate analysis. In a subgroup selected to be similar to the Diabetes Control and Complications Trial (DCCT) cohort, the rate of severe hypoglycaemia was 0.35 episodes/patient-year and only retinopathy was a significant risk marker together with state of awareness.CONCLUSION: Severe hypoglycaemia remains a significant clinical problem in type 1 diabetes. The rate of severe hypoglycaemia and the influence of risk markers are very sensitive to selection and differences in rates between centres or studies seem to disappear after correction for differences in clinical characteristics. Smoking is a novel overall risk marker of severe hypoglycaemia.",
keywords = "Adult, Aged, Aged, 80 and over, Awareness, Biomarkers, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Diabetic Neuropathies, Female, Humans, Hypoglycemia, Incidence, Male, Middle Aged, Multivariate Analysis, Patient Selection, Peripheral Nervous System Diseases, Risk Factors, Severity of Illness Index, Smoking, Surveys and Questionnaires, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't",
author = "Ulrik Pedersen-Bjergaard and Stig Pramming and Heller, {Simon R} and Wallace, {Tara M} and Rasmussen, {Ase K} and J{\o}rgensen, {Hanne V} and Matthews, {David R} and Philip Hougaard and Birger Thorsteinsson",
note = "Copyright 2004 John Wiley & Sons, Ltd.",
year = "2004",
month = sep,
day = "24",
doi = "10.1002/dmrr.482",
language = "English",
volume = "20",
pages = "479--86",
journal = "Diabetes - Metabolism: Research and Reviews",
issn = "1520-7552",
publisher = "John/Wiley & Sons Ltd",
number = "6",

}

RIS

TY - JOUR

T1 - Severe hypoglycaemia in 1076 adult patients with type 1 diabetes

T2 - influence of risk markers and selection

AU - Pedersen-Bjergaard, Ulrik

AU - Pramming, Stig

AU - Heller, Simon R

AU - Wallace, Tara M

AU - Rasmussen, Ase K

AU - Jørgensen, Hanne V

AU - Matthews, David R

AU - Hougaard, Philip

AU - Thorsteinsson, Birger

N1 - Copyright 2004 John Wiley & Sons, Ltd.

PY - 2004/9/24

Y1 - 2004/9/24

N2 - BACKGROUND: Differences between studies in rates of severe hypoglycaemia in type 1 diabetic cohorts are common and poorly understood. The purpose of this study was to assess the frequency of severe hypoglycaemia in unselected patients treated in different secondary care centres and to evaluate the influence of risk markers, clinical setting and selection.METHODS: Cross-sectional Danish-British multicentre survey of 1076 consecutive adult patients with clinical type 1 diabetes who completed a detailed questionnaire on hypoglycaemia and related issues. Key variable was the self-reported rate of severe hypoglycaemia during the preceding year.RESULTS: The overall rate of severe hypoglycaemia in the preceding year was 1.3 episodes/patient-year and episodes were reported by 36.7% of subjects. The distribution was highly skewed with 5% of subjects accounting for 54% of all episodes. There were no significant differences between countries or centres. Reduced hypoglycaemia awareness, peripheral neuropathy and smoking were the only significant risk markers of severe hypoglycaemia in a stepwise multivariate analysis. In a subgroup selected to be similar to the Diabetes Control and Complications Trial (DCCT) cohort, the rate of severe hypoglycaemia was 0.35 episodes/patient-year and only retinopathy was a significant risk marker together with state of awareness.CONCLUSION: Severe hypoglycaemia remains a significant clinical problem in type 1 diabetes. The rate of severe hypoglycaemia and the influence of risk markers are very sensitive to selection and differences in rates between centres or studies seem to disappear after correction for differences in clinical characteristics. Smoking is a novel overall risk marker of severe hypoglycaemia.

AB - BACKGROUND: Differences between studies in rates of severe hypoglycaemia in type 1 diabetic cohorts are common and poorly understood. The purpose of this study was to assess the frequency of severe hypoglycaemia in unselected patients treated in different secondary care centres and to evaluate the influence of risk markers, clinical setting and selection.METHODS: Cross-sectional Danish-British multicentre survey of 1076 consecutive adult patients with clinical type 1 diabetes who completed a detailed questionnaire on hypoglycaemia and related issues. Key variable was the self-reported rate of severe hypoglycaemia during the preceding year.RESULTS: The overall rate of severe hypoglycaemia in the preceding year was 1.3 episodes/patient-year and episodes were reported by 36.7% of subjects. The distribution was highly skewed with 5% of subjects accounting for 54% of all episodes. There were no significant differences between countries or centres. Reduced hypoglycaemia awareness, peripheral neuropathy and smoking were the only significant risk markers of severe hypoglycaemia in a stepwise multivariate analysis. In a subgroup selected to be similar to the Diabetes Control and Complications Trial (DCCT) cohort, the rate of severe hypoglycaemia was 0.35 episodes/patient-year and only retinopathy was a significant risk marker together with state of awareness.CONCLUSION: Severe hypoglycaemia remains a significant clinical problem in type 1 diabetes. The rate of severe hypoglycaemia and the influence of risk markers are very sensitive to selection and differences in rates between centres or studies seem to disappear after correction for differences in clinical characteristics. Smoking is a novel overall risk marker of severe hypoglycaemia.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Awareness

KW - Biomarkers

KW - Cross-Sectional Studies

KW - Diabetes Mellitus, Type 1

KW - Diabetic Neuropathies

KW - Female

KW - Humans

KW - Hypoglycemia

KW - Incidence

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Patient Selection

KW - Peripheral Nervous System Diseases

KW - Risk Factors

KW - Severity of Illness Index

KW - Smoking

KW - Surveys and Questionnaires

KW - Journal Article

KW - Multicenter Study

KW - Research Support, Non-U.S. Gov't

U2 - 10.1002/dmrr.482

DO - 10.1002/dmrr.482

M3 - Journal article

C2 - 15386817

VL - 20

SP - 479

EP - 486

JO - Diabetes - Metabolism: Research and Reviews

JF - Diabetes - Metabolism: Research and Reviews

SN - 1520-7552

IS - 6

ER -

ID: 51548556