OBJECTIVE: To evaluate the association of biochemical hypoglycemia with subsequent severe hypoglycemia (SH) events using the Diabetes Control and Complications Trial (DCCT) data set. RESEARCH DESIGN AND METHODS: The frequency of biochemical hypoglycemia (percentage of values <70 and <54 mg/dL [3.9 and 3.0 mmol/L) was assessed using DCCT blood glucose concentrations measured at a central laboratory from seven finger-stick samples (7-point testing: pre- and 90-min postmeals and at bedtime) collected during 1 day every 3 months. SH events required a change in mental status necessitating the involvement of another individual to provide treatment. A Poisson model accounting for repeated measures from each participant was used to assess the association of biochemical hypoglycemia frequency, computed from the 7-point finger-stick data, with the development of SH events. RESULTS: The risk of SH during a 3-month period was substantially higher (P < 0.001) when there was at least one hypoglycemic blood glucose value in the preceding 7-point profile, with similar results seen for both the 70 mg/dL (rate ratio = 3.0 [95% confidence interval: 2.6-3.3]) and 54 mg/dL (rate ratio = 2.7 [95% confidence interval: 2.4-3.1]) thresholds. CONCLUSIONS: The occurrence of biochemical hypoglycemia <70 or <54 mg/dL is associated with an increased risk of SH. For this reason as well as the deleterious effects of hypoglycemia on glucose counter-regulation and hypoglycemia awareness, cognition, quality of life, and arrhythmias, it is important in diabetes management to avoid hypoglycemic glucose levels as much as possible.
OBJECTIVE: To evaluate the association of biochemical hypoglycemia with subsequent severe hypoglycemia (SH) events using the Diabetes Control and Complications Trial (DCCT) data set. RESEARCH DESIGN AND METHODS: The frequency of biochemical hypoglycemia (percentage of values <70 and <54 mg/dL [3.9 and 3.0 mmol/L) was assessed using DCCT blood glucose concentrations measured at a central laboratory from seven finger-stick samples (7-point testing: pre- and 90-min postmeals and at bedtime) collected during 1 day every 3 months. SH events required a change in mental status necessitating the involvement of another individual to provide treatment. A Poisson model accounting for repeated measures from each participant was used to assess the association of biochemical hypoglycemia frequency, computed from the 7-point finger-stick data, with the development of SH events. RESULTS: The risk of SH during a 3-month period was substantially higher (P < 0.001) when there was at least one hypoglycemic blood glucose value in the preceding 7-point profile, with similar results seen for both the 70 mg/dL (rate ratio = 3.0 [95% confidence interval: 2.6-3.3]) and 54 mg/dL (rate ratio = 2.7 [95% confidence interval: 2.4-3.1]) thresholds. CONCLUSIONS: The occurrence of biochemical hypoglycemia <70 or <54 mg/dL is associated with an increased risk of SH. For this reason as well as the deleterious effects of hypoglycemia on glucose counter-regulation and hypoglycemia awareness, cognition, quality of life, and arrhythmias, it is important in diabetes management to avoid hypoglycemic glucose levels as much as possible.
Entities:
Keywords:
Biochemical hypoglycemia; Risk assessment; Severe hypoglycemia; Type 1 diabetes.
Authors: B P Kovatchev; D J Cox; L S Farhy; M Straume; L Gonder-Frederick; W L Clarke Journal: J Clin Endocrinol Metab Date: 2000-11 Impact factor: 5.958
Authors: Ruth S Weinstock; Stephanie N DuBose; Richard M Bergenstal; Naomi S Chaytor; Christina Peterson; Beth A Olson; Medha N Munshi; Alysa J S Perrin; Kellee M Miller; Roy W Beck; David R Liljenquist; Grazia Aleppo; John B Buse; Davida Kruger; Anuj Bhargava; Robin S Goland; Rachel C Edelen; Richard E Pratley; Anne L Peters; Henry Rodriguez; Andrew J Ahmann; John-Paul Lock; Satish K Garg; Michael R Rickels; Irl B Hirsch Journal: Diabetes Care Date: 2015-12-17 Impact factor: 19.112
Authors: Ruth E Davis; Malcolm Morrissey; John R Peters; Kim Wittrup-Jensen; Tessa Kennedy-Martin; Craig J Currie Journal: Curr Med Res Opin Date: 2005-09 Impact factor: 2.580
Authors: Roy W Beck; Richard M Bergenstal; Tonya D Riddlesworth; Craig Kollman; Zhaomian Li; Adam S Brown; Kelly L Close Journal: Diabetes Care Date: 2018-10-23 Impact factor: 19.112
Authors: Peter Novodvorsky; Alan Bernjak; Elaine Chow; Ahmed Iqbal; Lianne Sellors; Scott Williams; Robert A Fawdry; Bhavin Parekh; Richard M Jacques; Jefferson L B Marques; Paul J Sheridan; Simon R Heller Journal: Diabetes Care Date: 2017-02-17 Impact factor: 19.112
Authors: John M Lachin; Ionut Bebu; Richard M Bergenstal; Rodica Pop-Busui; F John Service; Bernard Zinman; David M Nathan Journal: Diabetes Care Date: 2017-04-12 Impact factor: 19.112
Authors: Cyril P Landstra; Axel Andres; Mikael Chetboun; Caterina Conte; Yvonne Kelly; Thierry Berney; Eelco J P de Koning; Lorenzo Piemonti; Peter G Stock; François Pattou; Marie-Christine Vantyghem; Melena D Bellin; Michael R Rickels Journal: J Clin Endocrinol Metab Date: 2021-09-27 Impact factor: 6.134
Authors: Tadej Battelino; Thomas Danne; Richard M Bergenstal; Stephanie A Amiel; Roy Beck; Torben Biester; Emanuele Bosi; Bruce A Buckingham; William T Cefalu; Kelly L Close; Claudio Cobelli; Eyal Dassau; J Hans DeVries; Kim C Donaghue; Klemen Dovc; Francis J Doyle; Satish Garg; George Grunberger; Simon Heller; Lutz Heinemann; Irl B Hirsch; Roman Hovorka; Weiping Jia; Olga Kordonouri; Boris Kovatchev; Aaron Kowalski; Lori Laffel; Brian Levine; Alexander Mayorov; Chantal Mathieu; Helen R Murphy; Revital Nimri; Kirsten Nørgaard; Christopher G Parkin; Eric Renard; David Rodbard; Banshi Saboo; Desmond Schatz; Keaton Stoner; Tatsuiko Urakami; Stuart A Weinzimer; Moshe Phillip Journal: Diabetes Care Date: 2019-06-08 Impact factor: 19.112
Authors: Itziar Oyagüez; Fernando Gómez-Peralta; Sara Artola; Francisco J Carrasco; Juana Carretero-Gómez; Javier García-Soidan; Ricardo Gómez-Huelgas; Juan F Merino-Torres; Antonio Pérez Journal: Diabetes Ther Date: 2021-05-04 Impact factor: 2.945
Authors: Itziar Oyagüez; Juan Francisco Merino-Torres; Miguel Brito; Virginia Bellido; Roque Cardona-Hernandez; Fernando Gomez-Peralta; Francisco Morales-Perez Journal: BMJ Open Diabetes Res Care Date: 2020-07
Authors: Arndís F Ólafsdóttir; Jan Bolinder; Tim Heise; William Polonsky; Magnus Ekelund; Magnus Wijkman; Aldina Pivodic; Elsa Ahlén; Erik Schwarcz; Thomas Nyström; Jarl Hellman; Irl B Hirsch; Marcus Lind Journal: Diabetes Obes Metab Date: 2020-12-10 Impact factor: 6.577