Association between hypoglycaemia and impaired hypoglycaemia awareness and mortality in people with Type 1 diabetes mellitus

A-S Sejling; B Schouwenberg; L H Faerch; B Thorsteinsson; B E de Galan; U Pedersen-Bjergaard

doi:10.1111/dme.12810

Association between hypoglycaemia and impaired hypoglycaemia awareness and mortality in people with Type 1 diabetes mellitus

A-S Sejling, B Schouwenberg, L H Faerch, B Thorsteinsson, B E de Galan, U Pedersen-Bjergaard

Department of Clinical Medicine

12 Citations (Scopus)

Abstract

AIMS: To examine whether severe hypoglycaemia and impaired hypoglycaemic awareness, a principal predictor of severe hypoglycaemia, are associated with all-cause mortality or cardiovascular mortality in Type 1 diabetes mellitus.

METHODS: Mortality was recorded in two cohorts, one in Denmark (n = 269, follow-up 12 years) and one in the Netherlands (n = 482, follow-up 6.5 years). In both cohorts, awareness class was characterized and numbers of episodes of severe hypoglycaemia either during lifetime (Danish cohort) or during the preceding year (Dutch cohort) were recorded. In addition, episodes of severe hypoglycaemia were prospectively recorded every month for 1 year in the Danish cohort. Follow-up data regarding mortality were obtained through medical reports and registries (Danish cohort).

RESULTS: All-cause mortality was 14% (n = 39) in the Danish and 4% (n = 20) in the Dutch cohort. In either cohort, neither presence of episodes with severe hypoglycaemia nor impaired hypoglycaemia awareness were associated with increased mortality in age-truncated Cox proportional hazard regression models. Variables associated with increased risk of all-cause mortality in both cohorts were evidence of macrovascular disease and reduced kidney function.

CONCLUSIONS: Severe hypoglycaemia and hypoglycaemia unawareness are not associated with increased risk of all-cause or cardiovascular mortality in people with Type 1 diabetes mellitus.

Original language	English
Journal	Diabetic Medicine
Volume	33
Issue number	1
Pages (from-to)	77-83
Number of pages	7
ISSN	0742-3071
DOIs	https://doi.org/10.1111/dme.12810
Publication status	Published - 1 Jan 2016

Keywords

Alcohol Drinking
Cardiovascular Diseases
Cohort Studies
Denmark
Diabetes Mellitus, Type 1
Diabetic Angiopathies
Diabetic Cardiomyopathies
Diabetic Nephropathies
Diagnostic Self Evaluation
Female
Follow-Up Studies
Humans
Hypoglycemia
Male
Middle Aged
Mortality
Netherlands
Outpatient Clinics, Hospital
Prevalence
Prospective Studies
Registries
Risk Factors
Severity of Illness Index
Survival Analysis
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/dme.12810

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title = "Association between hypoglycaemia and impaired hypoglycaemia awareness and mortality in people with Type 1 diabetes mellitus",

abstract = "AIMS: To examine whether severe hypoglycaemia and impaired hypoglycaemic awareness, a principal predictor of severe hypoglycaemia, are associated with all-cause mortality or cardiovascular mortality in Type 1 diabetes mellitus.METHODS: Mortality was recorded in two cohorts, one in Denmark (n = 269, follow-up 12 years) and one in the Netherlands (n = 482, follow-up 6.5 years). In both cohorts, awareness class was characterized and numbers of episodes of severe hypoglycaemia either during lifetime (Danish cohort) or during the preceding year (Dutch cohort) were recorded. In addition, episodes of severe hypoglycaemia were prospectively recorded every month for 1 year in the Danish cohort. Follow-up data regarding mortality were obtained through medical reports and registries (Danish cohort).RESULTS: All-cause mortality was 14% (n = 39) in the Danish and 4% (n = 20) in the Dutch cohort. In either cohort, neither presence of episodes with severe hypoglycaemia nor impaired hypoglycaemia awareness were associated with increased mortality in age-truncated Cox proportional hazard regression models. Variables associated with increased risk of all-cause mortality in both cohorts were evidence of macrovascular disease and reduced kidney function.CONCLUSIONS: Severe hypoglycaemia and hypoglycaemia unawareness are not associated with increased risk of all-cause or cardiovascular mortality in people with Type 1 diabetes mellitus.",

keywords = "Alcohol Drinking, Cardiovascular Diseases, Cohort Studies, Denmark, Diabetes Mellitus, Type 1, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Nephropathies, Diagnostic Self Evaluation, Female, Follow-Up Studies, Humans, Hypoglycemia, Male, Middle Aged, Mortality, Netherlands, Outpatient Clinics, Hospital, Prevalence, Prospective Studies, Registries, Risk Factors, Severity of Illness Index, Survival Analysis, Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't",

author = "A-S Sejling and B Schouwenberg and Faerch, {L H} and B Thorsteinsson and {de Galan}, {B E} and U Pedersen-Bjergaard",

note = "{\textcopyright} 2015 The Authors. Diabetic Medicine {\textcopyright} 2015 Diabetes UK.",

year = "2016",

month = jan,

day = "1",

doi = "10.1111/dme.12810",

language = "English",

volume = "33",

pages = "77--83",

journal = "Diabetic Medicine",

issn = "0742-3071",

publisher = "Wiley-Blackwell",

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TY - JOUR

T1 - Association between hypoglycaemia and impaired hypoglycaemia awareness and mortality in people with Type 1 diabetes mellitus

AU - Sejling, A-S

AU - Schouwenberg, B

AU - Faerch, L H

AU - Thorsteinsson, B

AU - de Galan, B E

AU - Pedersen-Bjergaard, U

PY - 2016/1/1

Y1 - 2016/1/1

N2 - AIMS: To examine whether severe hypoglycaemia and impaired hypoglycaemic awareness, a principal predictor of severe hypoglycaemia, are associated with all-cause mortality or cardiovascular mortality in Type 1 diabetes mellitus.METHODS: Mortality was recorded in two cohorts, one in Denmark (n = 269, follow-up 12 years) and one in the Netherlands (n = 482, follow-up 6.5 years). In both cohorts, awareness class was characterized and numbers of episodes of severe hypoglycaemia either during lifetime (Danish cohort) or during the preceding year (Dutch cohort) were recorded. In addition, episodes of severe hypoglycaemia were prospectively recorded every month for 1 year in the Danish cohort. Follow-up data regarding mortality were obtained through medical reports and registries (Danish cohort).RESULTS: All-cause mortality was 14% (n = 39) in the Danish and 4% (n = 20) in the Dutch cohort. In either cohort, neither presence of episodes with severe hypoglycaemia nor impaired hypoglycaemia awareness were associated with increased mortality in age-truncated Cox proportional hazard regression models. Variables associated with increased risk of all-cause mortality in both cohorts were evidence of macrovascular disease and reduced kidney function.CONCLUSIONS: Severe hypoglycaemia and hypoglycaemia unawareness are not associated with increased risk of all-cause or cardiovascular mortality in people with Type 1 diabetes mellitus.

AB - AIMS: To examine whether severe hypoglycaemia and impaired hypoglycaemic awareness, a principal predictor of severe hypoglycaemia, are associated with all-cause mortality or cardiovascular mortality in Type 1 diabetes mellitus.METHODS: Mortality was recorded in two cohorts, one in Denmark (n = 269, follow-up 12 years) and one in the Netherlands (n = 482, follow-up 6.5 years). In both cohorts, awareness class was characterized and numbers of episodes of severe hypoglycaemia either during lifetime (Danish cohort) or during the preceding year (Dutch cohort) were recorded. In addition, episodes of severe hypoglycaemia were prospectively recorded every month for 1 year in the Danish cohort. Follow-up data regarding mortality were obtained through medical reports and registries (Danish cohort).RESULTS: All-cause mortality was 14% (n = 39) in the Danish and 4% (n = 20) in the Dutch cohort. In either cohort, neither presence of episodes with severe hypoglycaemia nor impaired hypoglycaemia awareness were associated with increased mortality in age-truncated Cox proportional hazard regression models. Variables associated with increased risk of all-cause mortality in both cohorts were evidence of macrovascular disease and reduced kidney function.CONCLUSIONS: Severe hypoglycaemia and hypoglycaemia unawareness are not associated with increased risk of all-cause or cardiovascular mortality in people with Type 1 diabetes mellitus.

KW - Alcohol Drinking

KW - Cardiovascular Diseases

KW - Cohort Studies

KW - Denmark

KW - Diabetes Mellitus, Type 1

KW - Diabetic Angiopathies

KW - Diabetic Cardiomyopathies

KW - Diabetic Nephropathies

KW - Diagnostic Self Evaluation

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Hypoglycemia

KW - Male

KW - Middle Aged

KW - Mortality

KW - Netherlands

KW - Outpatient Clinics, Hospital

KW - Prevalence

KW - Prospective Studies

KW - Registries

KW - Risk Factors

KW - Severity of Illness Index

KW - Survival Analysis

KW - Journal Article

KW - Multicenter Study

KW - Observational Study

KW - Research Support, Non-U.S. Gov't

U2 - 10.1111/dme.12810

DO - 10.1111/dme.12810

M3 - Journal article

C2 - 25997108

SN - 0742-3071

VL - 33

SP - 77

EP - 83

JO - Diabetic Medicine

JF - Diabetic Medicine

IS - 1

ER -

Association between hypoglycaemia and impaired hypoglycaemia awareness and mortality in people with Type 1 diabetes mellitus

Abstract

Keywords

UN SDGs

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