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Research article:

HbA1C variability and hypoglycemia hospitalization in adults with type 1 and type 2 diabetes: a nested case-control study

Reference:

Victor W. Zhong; Juhaeri Juhaeri; Stephen R. Cole; Christina M. Shay; Penny Gordon-Larsen; Evangelos Kontopantelis; Elizabeth J Mayer-Davis(2017) HbA1C variability and hypoglycemia hospitalization in adults with type 1 and type 2 diabetes: a nested case-control study. Journal of Diabetes and its Complications, doi: http://dx.doi.org/10.1016/j.jdiacomp.2017.10.008

Link to article
Abstract
Aims: To determine association between HbA1C variability and hypoglycemia requiring hospitalization (HH) in adults with type 1 diabetes (T1D) and type 2 diabetes (T2D). Methods: Using nested case-control design in electronic health record data in England, one case with first or recurrent HH was matched to one control who had not experienced HH in incident T1D and T2D adults. HbA1C variability was determined by standard deviation of ≥3 HbA1C results. Conditional logistic models were applied to determine association of HbA1C variability with first and recurrent HH. Results: In T1D, every 1.0% increase in HbA1C variability was associated with 90% higher first HH risk (95% CI, 1.25-2.89) and 392% higher recurrent HH risk (95% CI, 1.17- 20.61). In T2D, a 1.0% increase in HbA1C variability was associated with 556% higher first HH risk (95% CI, 3.88-11.08) and 573% higher recurrent HH risk (95% CI, 1.59-28.51). In T2D for first HH, the association was the strongest in non-insulin non-sulfonylurea users (P<0.0001); for recurrent HH, the association was stronger in insulin users than sulfonylurea users (P=0.07). The HbA1C variability-HH association was stronger in more recent years in T2D (P≤0.004). Conclusions: HbA1C variability is a strong predictor for HH in T1D and T2D.
Author for correspondence
Elizabeth J Mayer-Davis
Email for correspondence
mayerdav@email.unc.edu

Code list: res50: Moderate or severe liver disease

35 codes in list

Code Coding system Description Entity type List name
7609 Read Open operations on oesophageal varices diagnostic res50: Moderate or severe liver disease
7609300 Read Local ligation of oesophageal varices diagnostic res50: Moderate or severe liver disease
7609400 Read Open injection sclerotherapy to oesophageal varices diagnostic res50: Moderate or severe liver disease
7609y00 Read Other specified open operation on oesophageal varices diagnostic res50: Moderate or severe liver disease
7609z00 Read Open operation on oesophageal varices NOS diagnostic res50: Moderate or severe liver disease
760C300 Read Fibreoptic endoscopic injection sclerotherapy oesoph varices diagnostic res50: Moderate or severe liver disease
760C500 Read Fibreoptic endoscopic banding of oesophageal varices diagnostic res50: Moderate or severe liver disease
760F300 Read Rigid oesophagoscopic injection sclerotherapy oesoph varices diagnostic res50: Moderate or severe liver disease
760F400 Read Rigid oesophagoscopic banding of oesophageal varices diagnostic res50: Moderate or severe liver disease
A053.00 Read Amoebic liver abscess diagnostic res50: Moderate or severe liver disease
A704z00 Read Other specified viral hepatitis with hepatic coma NOS diagnostic res50: Moderate or severe liver disease
G850.00 Read Oesophageal varices with bleeding diagnostic res50: Moderate or severe liver disease
G851.00 Read Oesophageal varices without bleeding diagnostic res50: Moderate or severe liver disease
G85..11 Read Oesophageal varices diagnostic res50: Moderate or severe liver disease
G852.00 Read Oesophageal varices in diseases EC diagnostic res50: Moderate or severe liver disease
G852000 Read Oesophageal varices with bleeding in diseases EC diagnostic res50: Moderate or severe liver disease
G852100 Read Oesophageal varices without bleeding in diseases EC diagnostic res50: Moderate or severe liver disease
G852200 Read Oesophageal varices in cirrhosis of the liver diagnostic res50: Moderate or severe liver disease
G852300 Read Oesophageal varices in alcoholic cirrhosis of the liver diagnostic res50: Moderate or severe liver disease
G852z00 Read Oesophageal varices in diseases EC NOS diagnostic res50: Moderate or severe liver disease
G858.00 Read Oesophageal varices NOS diagnostic res50: Moderate or severe liver disease
Gyu9400 Read [X]Oesophageal varices in diseases classified elsewhere diagnostic res50: Moderate or severe liver disease
J62..00 Read Liver abscess and sequelae of chronic liver disease diagnostic res50: Moderate or severe liver disease
J620.00 Read Liver abscess - excluding amoebic liver abscess diagnostic res50: Moderate or severe liver disease
J620000 Read Liver abscess due to portal pyaemia diagnostic res50: Moderate or severe liver disease
J620100 Read Liver abscess due to cholangitis diagnostic res50: Moderate or severe liver disease
J620200 Read Liver abscess via hepatic artery diagnostic res50: Moderate or severe liver disease
J620300 Read Liver abscess via umbilicus diagnostic res50: Moderate or severe liver disease
J620z00 Read Liver abscess NOS diagnostic res50: Moderate or severe liver disease
J622.00 Read Hepatic coma diagnostic res50: Moderate or severe liver disease
J623.00 Read Portal hypertension diagnostic res50: Moderate or severe liver disease
J624.00 Read Hepatorenal syndrome diagnostic res50: Moderate or severe liver disease
J62y.00 Read Other sequelae of chronic liver disease diagnostic res50: Moderate or severe liver disease
J62z.00 Read Liver abscess and chronic liver disease causing sequelae NOS diagnostic res50: Moderate or severe liver disease
SP14300 Read Hepatorenal syndrome as a complication of care diagnostic res50: Moderate or severe liver disease

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