Characteristics of Patients With Type 2 Diabetes Associated With Severe Hypoglycemia

June 2018. To identify characteristics typical of patients with severe hypoglycemia, electronic medical records of 50,439 patients with type 2 diabetes receiving care from the Cleveland Clinic Health System were used to identify the severe hypoglycemia events from 2006 to 2015. A severe hypoglycemia event was defined as hypoglycemia requiring an emergency department visit or hospitalization. Between 2006 and 2015, the incidence of severe hypoglycemia increased from 0.12% to 0.31% (P=0.01). Patients who experienced severe hypoglycemia had similar A1C levels to those who did not experience severe hypoglycemia. Odds of a severe hypoglycemic event increased in patients with A1C <6% (odds ratio [OR] 1.95; P<0.001) and a history of nonsevere hypoglycemia (OR 3.01; P<0.001). Other identified factors for higher risk were black race, higher number of diabetes medications, increased Charlson comorbidity index, and insulin and/or sulfonylurea use. Patients at lower risk were those with a higher body mass index, and/or who used metformin, dipeptidyl peptidase-4 inhibitors, or glucagon-like peptide 1 receptor agonists. The study authors indicated that identifying and modifying risk factors among patients with previous nonsevere hypoglycemia may help prevent future episodes of severe hypoglycemia. Read the abstract here.