Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Incidence and determinants of minor and major hypoglycaemia in type 2 diabetes (#195)

Rebecca Goldstein 1 2 , Neale Cohen 3 , Esther Briganti 4
  1. Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
  2. Monash Centre for Health, Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  3. Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
  4. Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia

Objective: To assess the incidence and risk factors of minor and major hypoglycaemia in patients with type 2 diabetes.

Research Design and Methods: This wasa retrospective, cross-sectional analysis of 2,272 adults with type 2 diabetes, attending a diabetes clinic between April 2008 to May 2011. Minor hypoglycaemia in the preceding month and major hypoglycaemia in the preceding 12 months were the primary outcomes. Logistic regression analysis was used to determine the following risk factors for minor and major hypoglycaemia: age, sex, diabetes duration , HbA1c, presence of cardiovascular disease, microalbuminuria, peripheral neuropathy, renal impairment, central obesity, activity level, smoking status, glycaemic therapy.

Results: The incidence of minor hypoglycaemia was 11.1%, while that of major hypoglycaemia was 0.7%. Among those not on insulin, the incidence of minor hypoglycaemia increased with the number of oral hypoglycaemic agents; each additional agent increased the relative risk of hypoglycaemia by 45%. The strongest independent predictor of minor hypoglycaemia was insulin use, while for major hypoglycaemia it was disease duration. Other independent predictors for minor hypoglycaemia were diabetes duration and the presence of peripheral neuropathy, while those for major hypoglycaemia were insulin use, cardiovascular disease and female sex.

Conclusions: In this large cohort with type 2 diabetes, insulin treatment and diabetes duration are strong and independent risk factors for minor and major hypoglycaemia. This study proposes that peripheral neuropathy may be a predictor of minor hypoglycaemia and demonstrates that cardiovascular disease is an important and novel predictor of major hypoglycaemia. Study findings can direct education regarding hypoglycaemia and development of strategies to reduce hypoglycaemia.