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Severe hypoglycemia led to early death, cancer in patients with diabetes
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Patients with type 2 diabetes who also develop severe hypoglycemia may be at greater risk for early death and various cancers, researchers in Hong Kong found.
A total of 8,767 patients (mean age, 57.4 years) both with and without severe hypoglycemia in the 12 months before enrollment, and with similar cancer rates, were recruited to a consecutive cohort through the Hong Kong Diabetes Registry.
The participants, who enrolled in the study between 1995 and 2007, were seen for follow-up either at the date of their first hospital admission for severe hypoglycemia or in January 2009.
Researchers identified risk factors for the condition based on demographic, lifestyle and clinically relevant factors, as well as drug use at enrollment. They also identified cancer-associated subphenotypes for it.
The clinical outcomes of severe hypoglycemia were ascertained through a centralized hospital computer system, which recorded diagnoses of all hospital discharges, including mortality based on ICD-9 codes. Cox proportional hazards regression was used to assess clinical factors for the condition.
During follow-up, patients with severe hypoglycemia had a higher incidence of all-site cancer (13.4% vs. 6.4%, P<.0001) and mortality (32.8% vs. 11.2%, P<.0001) than those without severe hypoglycemia, according to the study.
Researchers also identified several risk factors as being predictive of severe hypoglycemia in patients with type 2 diabetes, including old age, low BMI, high HbA1c, low triglycerides, low LDL-C, albuminuria and chronic kidney disease.
“Given the complexity and multiple comorbidities of type 2 diabetes, experts have emphasized the importance of periodic phenotyping, individualizing treatment goals, and co-management of specialist and primary care, especially in difficult-to-treat patients such as those with hypoglycemia, poor glycemic control, and comorbidities,” the researchers wrote.
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