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Impact of severe hypoglycaemia requiring hospitalization on mortality in people with type 1 diabetes: A national retrospective observational cohort study

Othmar Moser Orcid Logo, James Rafferty, Max L. Eckstein, Faisal Aziz Orcid Logo, Steve Bain Orcid Logo, Richard Bergenstal Orcid Logo, Harald Sourij Orcid Logo, Becky Thomas Orcid Logo, Jim Rafferty Orcid Logo

Diabetes, Obesity and Metabolism, Volume: 25, Issue: 8, Pages: 2243 - 2254

Swansea University Authors: Steve Bain Orcid Logo, Becky Thomas Orcid Logo, Jim Rafferty Orcid Logo

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DOI (Published version): 10.1111/dom.15102

Abstract

AimsTo assess if the risk of all-cause mortality increases in people with type 1 diabetes (T1D) with increasing number of severe hypoglycaemia episodes requiring hospitalization.Materials and methodsWe conducted a national retrospective observational cohort study in people with T1D (diagnosed betwee...

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Published in: Diabetes, Obesity and Metabolism
ISSN: 1462-8902 1463-1326
Published: Wiley 2023
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa63399
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Abstract: AimsTo assess if the risk of all-cause mortality increases in people with type 1 diabetes (T1D) with increasing number of severe hypoglycaemia episodes requiring hospitalization.Materials and methodsWe conducted a national retrospective observational cohort study in people with T1D (diagnosed between 2000 and 2018). Clinical, comorbidity and demographic variables were assessed for impact on mortality for people with no, one, two and three or more episodes of severe hypoglycaemia requiring hospitalization. The time to death (all-cause mortality) from the timepoint of the last episode of severe hypoglycaemia was modelled using a parametric survival model.ResultsA total of 8224 people had a T1D diagnosis in Wales during the study period. The mortality rate (95% confidence interval [CI]) was 6.9 (6.1-7.8) deaths/ 1000 person-years (crude) and 15.31 (13.3-17.63) deaths/ 1000 person-years (age-adjusted) for those with no occurrence of severe hypoglycaemia requiring hospitalization. For those with one episode of severe hypoglycaemia requiring hospitalization the mortality rate (95% CI) was 24.9 (21.0-29.6; crude) and 53.8 (44.6-64.7) deaths/ 1000 person-years (age-adjusted), for those with two episodes of severe hypoglycaemia requiring hospitalization it was 28.0 (23.1-34.0; crude) and 72.8 (59.2-89.5) deaths/ 1000 person-years (age-adjusted), and for those with three or more episodes of severe hypoglycaemia requiring hospitalization it was 33.5 (30.0-37.3; crude) and 86.3 (71.7-103.9) deaths/ 1000 person years (age-adjusted; P < 0.001). A parametric survival model showed that having two episodes of severe hypoglycaemia requiring hospitalization was the strongest predictor for time to death (accelerated failure time coefficient 0.073 [95% CI 0.009-0.565]), followed by having one episode of severe hypoglycaemia requiring hospitalization (0.126 [0.036-0.438]) and age at most recent episode of severe hypoglycaemia requiring hospitalization (0.917 [0.885-0.951]).ConclusionsThe strongest predictor for time to death was having two or more episodes of severe hypoglycaemia requiring hospitalization.
Keywords: mortality, risk prediction, severe hypoglycaemia, type 1 diabetes
College: Faculty of Medicine, Health and Life Sciences
Issue: 8
Start Page: 2243
End Page: 2254