Risk Factors for Severe Hypoglycemia in Adults With Diabetes

December 1, 2017. Assessing hypoglycemia risk is essential when individualizing diabetes care. This studied aimed to evaluate risk factors for severe hypoglycemia over a median 15.2 years among 1,206 participants with diabetes, using data from the ongoing, prospective Atherosclerosis Risk in Communities (ARIC) cohort study. Mean participant age was 64 years, 46% were male, and 32% were black. Using hospitalization, emergency department visit, and ambulance use claims from 1996-2013, the following risk factors were identified: age (per 5 years; hazard ratio [HR] 1.24; 95% confidence interval [CI] 1.07-1.43), black race (HR 1.39; 95% CI 1.02-1.88), insulin use vs no medications and oral medications only vs no medications (HR 3.00; 95% CI 1.71-5.28 and HR 2.20; 95% CI 1.28-3.76, respectively), poor vs good and moderate vs good glycemic control (HR 2.62; 95% CI 1.67-4.10 and HR 1.78; 95% CI 1.11-2.83, respectively), macroalbuminuria (HR 1.95; 95% CI 1.23-3.07), and poor cognitive function (HR 1.57; 95% CI 1.33-1.84). Low 1,5-anhydroglucitol, use of Medicaid insurance, difficulty with activities of daily living, and antidepressant use were also associated with an increased risk of severe hypoglycemia. Read the abstract here.