| Abstract: | Aims/hypothesis We explored the epidemiology of hypoglycaemia in individuals with insulin-treated diabetes by testing the hypothesis that
diabetes type and duration of insulin treatment influence the risk of hypoglycaemia.
Materials and methods This was an observational study over 9–12 months in six UK secondary care diabetes centres. Altogether 383 patients were involved.
Patients were divided into the following three treatment groups for type 2 diabetes: (1) sulfonylureas, (2) insulin for <2 years
and (3) insulin for >5 years, and into two treatment groups for type 1 diabetes, namely <5 years disease duration and >15 years
disease duration. Self-reported (mild and severe) and biochemical episodes (interstitial glucose <2.2 mmol/l using continuous
glucose monitoring) were recorded.
Results Mild hypoglycaemia in type 2 diabetic patients on insulin for <2 years was less frequent than in type 1 patients with <5 years
disease duration (mean rate: 4 vs 36 episodes per subject-year, p < 0.001). In type 2 diabetic patients treated with sulfonylureas or insulin for <2 years, no differences were observed in
the proportion experiencing severe hypoglycaemia (7 vs 7%, difference 0 95% CI: −7 to 9%]), mild symptomatic (39 vs 51%,
difference 12 −3 to 25%]) or interstitial glucose <2.2 mol/l (22 vs 20%, difference 2 −13 to 10%]). Severe hypoglycaemia
rates were comparable in patients with type 2 diabetes on sulfonylureas or insulin < 2 years (0.1 and 0.2 episodes per subject-year)
and far less frequent than in type 1 diabetes (<5 years group, 1.1; >15 years group, 3.2.episodes per subject-year).
Conclusions/interpretation During early insulin use in type 2 diabetes, the frequency of hypoglycaemia is generally equivalent to that observed in patients
treated with sulfonylureas and considerably lower than during the first 5 years of treatment in type 1 diabetes.
UK Hypoglycaemia Study Group: For a list of the members of this group and their affiliations, see the Appendix. UK Hypoglycaemia Study Group: For a list of each author’s contribution to this study, see the Electronic supplementary material (ESM) which is available to authorised users at doi:.
Send any feedback or comments on this article to Simon Heller at the Academic Unit of Diabetes, Endocrinology and Metabolism,
School of Medicine and Biomedical Sciences, Room OU141, Beech Hill Road, Sheffield S10 2RX, UK. s.heller@sheffield.ac.uk. |
