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||Coding System (CPRD_product_code)||Entity type||Category|
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|35149||Exenatide 10micrograms/0.04ml solution for injection 2.4ml pre-filled disposable||CPRD_product_code||res50: GLP-1 receptor agonists||drug|
|35150||Byetta 10micrograms/0.04ml solution for injection 2.4ml pre-filled disposable dev||CPRD_product_code||res50: GLP-1 receptor agonists||drug|
|35251||Exenatide 5micrograms/0.02ml solution for injection 1.2ml pre-filled disposable d||CPRD_product_code||res50: GLP-1 receptor agonists||drug|
|40642||Victoza 6mg/ml solution for injection 3ml pre-filled pen (Novo Nordisk Ltd)||CPRD_product_code||res50: GLP-1 receptor agonists||drug|
|40693||Liraglutide 6mg/ml solution for injection 3ml pre-filled disposable devices||CPRD_product_code||res50: GLP-1 receptor agonists||drug|
|46458||Exenatide 2mg powder and solvent for suspension for injection vials||CPRD_product_code||res50: GLP-1 receptor agonists||drug|
|46469||Bydureon 2mg powder and solvent for suspension for injection vials (AstraZeneca U||CPRD_product_code||res50: GLP-1 receptor agonists||drug|
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