Self-reported hypoglycaemia in patients with type 2 diabetes treated with insulin in the Hoorn Diabetes Care System Cohort, the Netherlands: a prospective cohort study.
BACKGROUND
Our aim was to study the prevalence of self-reported hypoglycaemic sensations and its association with mortality in patients with type 2 diabetes (T2D) treated with insulin in usual care.


METHODS
Demographics, clinical characteristics and mortality data were obtained from 1667 patients with T2D treated with insulin in the Hoorn Diabetes Care System Cohort (DCS), a prospective cohort study using clinical care data. Self-reported hypoglycaemic sensations were defined as either mild: events not requiring help; or severe: events requiring help from others (either medical assistance or assistance of others). The association between hypoglycaemic sensations and mortality was analysed using logistic regression analysis.


RESULTS
At baseline, 981 patients (59%) reported no hypoglycaemic sensations in the past year, 612 (37%) reported only mild sensations and 74 (4%) reported severe hypoglycaemic sensations. During a median follow-up of 1.9 years, 98 patients (5.9%) died. Reporting only mild hypoglycaemic sensations was associated with a lower mortality risk (OR 0.48, 95% CI 0.28 to 0.80), while reporting severe sensations was not significantly associated with mortality (OR 0.76, 95% CI 0.33 to 1.80), compared with reporting no hypoglycaemic sensations, and adjusting for demographic and clinical characteristics. Sensitivity analyses showed an OR of 1.38 (95% CI 0.31 to 6.11) for patients reporting severe hypoglycaemic sensations requiring medical assistance.


CONCLUSIONS
Self-reported hypoglycaemic sensations are highly prevalent in our insulin-treated T2D population. Patients reporting hypoglycaemic sensations not requiring medical assistance did not have an increased risk of mortality, suggesting that these sensations are not an indicator of increased short-term mortality risk in patients with T2D.
['Rauh|Simone P|SP|0000-0003-3627-6925', 'Rutters|Femke|F|', 'Thorsted|Brian L|BL|', 'Wolden|Michael L|ML|', 'Nijpels|Giel|G|', 'van der Heijden|Amber A W A|AA|', 'Walraven|Iris|I|', 'Elders|Petra J|PJ|', 'Heymans|Martijn W|MW|', 'Dekker|Jacqueline M|JM|']
D000368:Aged D015331:Cohort Studies D015897:Comorbidity D003924:Diabetes Mellitus, Type 2 D005260:Female D006801:Humans D007003:Hypoglycemia D007004:Hypoglycemic Agents D007328:Insulin D008297:Male D008875:Middle Aged D009426:Netherlands D011446:Prospective Studies D057566:Self Report
DIABETES & ENDOCRINOLOGY EPIDEMIOLOGY