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. 2012 May;35(5):972-5.
doi: 10.2337/dc11-1470. Epub 2012 Mar 12.

Substantial increase in incidence of severe hypoglycemia between 1997-2000 and 2007-2010: a German longitudinal population-based study

Andreas Holstein  1 , Olaf M Patzer, Kathrin Machalke, Judith D Holstein, Michael Stumvoll, Peter Kovacs
Affiliations

Substantial increase in incidence of severe hypoglycemia between 1997-2000 and 2007-2010: a German longitudinal population-based study

Andreas Holstein et al. Diabetes Care. 2012 May.

Abstract

Objective: To compare the incidences of severe hypoglycemia and corresponding clinical circumstances in a German population between 2007-2010 and 1997-2000.

Research design and methods: A screening for severe hypoglycemia was performed in the Lippe-Detmold area in Germany to sensitively detect severe hypoglycemia. This was defined as a symptomatic event requiring treatment with intravenous glucose and being confirmed by a blood glucose measurement of <50 mg/dL.

Results: Severe hypoglycemia increased considerably from 264 events in 1997-2000 to 495 events in 2007-2010, which translated into an increase in frequency of severe hypoglycemia among all emergency admissions from 0.68 to 0.83% (P = 0.015). This was mostly related to intensification of antihyperglycemic therapy, particularly in the increasingly morbid group of hypoglycemic patients with type 2 diabetes indicated by lower HbA(1c), more comedication (3.3 vs. 7.7 drugs), and more concomitant diseases (3.6 vs. 4.4) (all P values <0.001).

Conclusions: Within a 10-year period, there was an intensification of antihyperglycemic therapy in increasingly comorbid subjects, leading to a considerably higher incidence of severe hypoglycemia.

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