To determine association between HbA1C variability and hypoglycemia requiring hospitalization (HH) in adults with type 1 diabetes (T1D) and type 2 diabetes (T2D).
Using nested case-control design in electronic health record data in England, one case with first or recurrent HH was matched to one control who had not experienced HH in incident T1D and T2D adults. HbA1C variability was determined by standard deviation of ≥3 HbA1C results. Conditional logistic models were applied to determine association of HbA1C variability with first and recurrent HH.
In T1D, every 1.0% increase in HbA1C variability was associated with 90% higher first HH risk (95% CI, 1.25–2.89) and 392% higher recurrent HH risk (95% CI, 1.17–20.61). In T2D, a 1.0% increase in HbA1C variability was associated with 556% higher first HH risk (95% CI, 3.88–11.08) and 573% higher recurrent HH risk (95% CI,1.59–28.51). In T2D for first HH, the association was the strongest in non-insulin non-sulfonylurea users (P b 0.0001); for recurrent HH, the association was stronger in insulin users than sulfonylurea users (P = 0.07). The HbA1C variability-HH association was stronger in more recent years in T2D (P ≤ 0.004).
HbA1C variability is a strong predictor for HH in T1D and T2D.
Victor W Zhong, Juhaeri Juhaeri, Stephen R Cole, Christian M Shay, Carolyn A Chew-Graham, Penny Gordon-Larsen, Evangelos Kontopantelis, Elizabeth J Mayer-Davis, HbA1C variability and hypoglycemia hospitalization in adults with type 1 and type 2 diabetes: A nested case-control study. Journal of Diabetes and Its Complications, 32(2), 2017.
|Code||Description||Entity type||Category||Coding System (Read)|
|A788.00||Acquired immune deficiency syndrome||res50: AIDS||diagnostic||Read|
|A788.11||Human immunodeficiency virus infection||res50: AIDS||diagnostic||Read|
|A788000||Acute human immunodeficiency virus infection||res50: AIDS||diagnostic||Read|
|A788100||Asymptomatic human immunodeficiency virus infection||res50: AIDS||diagnostic||Read|
|A788200||HIV infection with persistent generalised lymphadenopathy||res50: AIDS||diagnostic||Read|
|A788300||Human immunodeficiency virus with constitutional disease||res50: AIDS||diagnostic||Read|
|A788400||Human immunodeficiency virus with neurological disease||res50: AIDS||diagnostic||Read|
|A788500||Human immunodeficiency virus with secondary infection||res50: AIDS||diagnostic||Read|
|A788600||Human immunodeficiency virus with secondary cancers||res50: AIDS||diagnostic||Read|
|A788W00||HIV disease resulting in unspecified malignant neoplasm||res50: AIDS||diagnostic||Read|
|A788X00||HIV disease resulting/unspcf infectious+parasitic disease||res50: AIDS||diagnostic||Read|
|A788y00||Human immunodeficiency virus with other clinical findings||res50: AIDS||diagnostic||Read|
|A788z00||Acquired human immunodeficiency virus infection syndrome NOS||res50: AIDS||diagnostic||Read|
|A789000||HIV disease resulting in mycobacterial infection||res50: AIDS||diagnostic||Read|
|A789100||HIV disease resulting in cytomegaloviral disease||res50: AIDS||diagnostic||Read|
|A789200||HIV disease resulting in candidiasis||res50: AIDS||diagnostic||Read|
|A789300||HIV disease resulting in Pneumocystis carinii pneumonia||res50: AIDS||diagnostic||Read|
|A789311||HIV disease resulting in Pneumocystis jirovecii pneumonia||res50: AIDS||diagnostic||Read|
|A789400||HIV disease resulting in multiple infections||res50: AIDS||diagnostic||Read|
|A789500||HIV disease resulting in Kaposi's sarcoma||res50: AIDS||diagnostic||Read|
|A789511||HIV disease resulting in Kaposi sarcoma||res50: AIDS||diagnostic||Read|
|A789600||HIV disease resulting in Burkitt's lymphoma||res50: AIDS||diagnostic||Read|
|A789700||HIV dis resulting oth types of non-Hodgkin's lymphoma||res50: AIDS||diagnostic||Read|
|A789800||HIV disease resulting in multiple malignant neoplasms||res50: AIDS||diagnostic||Read|
|A789900||HIV disease resulting in lymphoid interstitial pneumonitis||res50: AIDS||diagnostic||Read|
|A789A00||HIV disease resulting in wasting syndrome||res50: AIDS||diagnostic||Read|
|A789X00||HIV dis reslt/oth mal neopl/lymph,h'matopoetc+reltd tissu||res50: AIDS||diagnostic||Read|
|AyuC.00||[X]Human immunodeficiency virus disease||res50: AIDS||diagnostic||Read|
|AyuC100||[X]HIV disease resulting in other viral infections||res50: AIDS||diagnostic||Read|
|AyuC300||[X]HIV disease resulting in multiple infections||res50: AIDS||diagnostic||Read|
|AyuC400||[X]HIV disease resulting/other infectious+parasitic diseases||res50: AIDS||diagnostic||Read|
|AyuC600||[X]HIV disease resulting in other non-Hodgkin's lymphoma||res50: AIDS||diagnostic||Read|
|AyuCC00||[X]HIV disease resulting in other specified conditions||res50: AIDS||diagnostic||Read|
|AyuCD00||[X]Unspecified human immunodeficiency virus [HIV] disease||res50: AIDS||diagnostic||Read|
|Eu02400||[X]Dementia in human immunodef virus [HIV] disease||res50: AIDS||diagnostic||Read|
|L179.00||HIV disease complicating pregnancy childbirth puerperium||res50: AIDS||diagnostic||Read|
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