TY - JOUR
T1 - Long-Term Prediction of Severe Hypoglycemia in Type 1 Diabetes
T2 - Is It Really Possible?
AU - Henriksen, Marie Moth
AU - Færch, Louise
AU - Thorsteinsson, Birger
AU - Pedersen-Bjergaard, Ulrik
N1 - © 2016 Diabetes Technology Society.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Background: Prediction of risk of severe hypoglycemia (SH) in patients with type 1 diabetes is important to prevent future episodes, but it is unknown if it is possible to predict the long-term risk of SH. The aim of the study is to assess if long-term prediction of SH is possible in type 1 diabetes. Methods: A follow-up study was performed with 98 patients with type 1 diabetes. At baseline and at follow-up, the patients filled in a questionnaire about diabetes history and complications, number of SH in the preceding year and state of awareness, and HbA1c and C-peptide levels were measured. Results: During the 12 years of follow-up, there was a decrease in HbA1c, C-peptide levels, and incidence of SH (1.1 to 0.4 episodes per patient-year; P <.001). At baseline, the relative rate of SH was 3.6 (P =.001) and 10.9 (P <.0001) in patients with impaired awareness and unawareness of hypoglycemia, respectively, as compared to patients with normal awareness. At follow-up, patients with unawareness at baseline tended to have maintained an increased rate of SH (RR = 3.1; P =.07). Impaired awareness, HbA1c and C-peptide determined at baseline did not correspond with an increased rate of SH at follow-up. Conclusions: Long-term prediction of severe hypoglycemia in type 1 diabetes was not possible, although baseline hypoglycemia unawareness tended to remain a predictor for risk of SH at follow-up. Therefore, it is important repeatedly to assess the different risk factors of SH to determine the actual risk.
AB - Background: Prediction of risk of severe hypoglycemia (SH) in patients with type 1 diabetes is important to prevent future episodes, but it is unknown if it is possible to predict the long-term risk of SH. The aim of the study is to assess if long-term prediction of SH is possible in type 1 diabetes. Methods: A follow-up study was performed with 98 patients with type 1 diabetes. At baseline and at follow-up, the patients filled in a questionnaire about diabetes history and complications, number of SH in the preceding year and state of awareness, and HbA1c and C-peptide levels were measured. Results: During the 12 years of follow-up, there was a decrease in HbA1c, C-peptide levels, and incidence of SH (1.1 to 0.4 episodes per patient-year; P <.001). At baseline, the relative rate of SH was 3.6 (P =.001) and 10.9 (P <.0001) in patients with impaired awareness and unawareness of hypoglycemia, respectively, as compared to patients with normal awareness. At follow-up, patients with unawareness at baseline tended to have maintained an increased rate of SH (RR = 3.1; P =.07). Impaired awareness, HbA1c and C-peptide determined at baseline did not correspond with an increased rate of SH at follow-up. Conclusions: Long-term prediction of severe hypoglycemia in type 1 diabetes was not possible, although baseline hypoglycemia unawareness tended to remain a predictor for risk of SH at follow-up. Therefore, it is important repeatedly to assess the different risk factors of SH to determine the actual risk.
KW - Journal Article
U2 - 10.1177/1932296816664745
DO - 10.1177/1932296816664745
M3 - Journal article
C2 - 27651425
SN - 1932-2968
VL - 10
SP - 1230
EP - 1235
JO - Journal of diabetes science and technology
JF - Journal of diabetes science and technology
IS - 6
ER -
