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. 2020 Sep;11(5):1258-1264.
doi: 10.1111/jdi.13253. Epub 2020 Apr 26.

Incidence of severe hypoglycemia and its association with serum adiponectin in Japanese patients with type 1 and insulin-treated type 2 diabetes: The Fukuoka Diabetes Registry

Masanori Iwase  1   2 , Yuji Komorita  1 , Hiroki Fujii  1 , Toshiaki Ohkuma  1 , Hitoshi Ide  1 , Masahito Yoshinari  1 , Yutaro Oku  1 , Taiki Higashi  1 , Udai Nakamura  1 , Takanari Kitazono  1
Affiliations

Incidence of severe hypoglycemia and its association with serum adiponectin in Japanese patients with type 1 and insulin-treated type 2 diabetes: The Fukuoka Diabetes Registry

Masanori Iwase et al. J Diabetes Investig. 2020 Sep.

Abstract

Aims/introduction: The incidence of severe hypoglycemia and its risk factors including an insulin-sensitizing adipokine, adiponectin, were prospectively investigated in Japanese patients with type 1 or insulin-treated type 2 diabetes.

Materials and methods: A total of 207 participants with type 1 diabetes (mean age 55 years) and 1,396 with insulin-treated type 2 diabetes (mean age 65 years) from the local diabetes registry were followed for 5 years (follow-up rate 99%). Severe hypoglycemia was defined as events requiring the assistance of others for recovery from hypoglycemia.

Results: The incidence of severe hypoglycemia was 9.2 per 100 person-years in those with type 1 diabetes, and 2.3 per 100 person-years in those with insulin-treated type 2 diabetes, respectively. For type 1 diabetes, the risk was significant in those with a history of severe hypoglycemia within the previous year, slow eating and higher serum adiponectin (the highest vs the lowest in quartile hazard ratio 2.36, 95% confidence interval 1.22-4.69). For insulin-treated type 2 diabetes, the risk included age ≥65 years, history of severe hypoglycemia within the previous year, alcohol consumption ≥60 g/day, larger insulin dose and higher serum adiponectin (the highest vs the lowest in quartile, hazard ratio 2.95, 95% confidence interval 1.22-4.69). For all participants, the incidence of severe hypoglycemia increased along with serum adiponectin (age- and sex-adjusted hazard ratio 1.65 per 1 standard deviation increase of log serum adiponectin, 95% confidence interval 1.45-1.87).

Conclusions: The incidence of severe hypoglycemia was prospectively determined, and the association between severe hypoglycemia and higher serum adiponectin was observed in Japanese patients with type 1 and insulin-treated type 2 diabetes.

Keywords: Adiponectin; Hypoglycemia; Insulin.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier curves for severe hypoglycemia in Japanese participants with type 1 diabetes (solid line) and insulin‐treated type 2 diabetes mellitus (broken line).
Figure 2
Figure 2
The relationship between serum adiponectin and the age‐ and sex‐adjusted incidence of severe hypoglycemia in participants with type 1 diabetes and insulin‐treated type 2 diabetes.
See this image and copyright information in PMC

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