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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: SGLT-2 inhibitors

8 codes in list

Code Coding system Description Entity type List name drugsubstance bnfcode bnfchapter
54182 CPRD_product_code Dapagliflozin 10mg tablets drug res50: SGLT-2 inhibitors Dapagliflozin 06010203 Other Antidiabetic Drugs
54203 CPRD_product_code Forxiga 10mg tablets (AstraZeneca UK Ltd) drug res50: SGLT-2 inhibitors Dapagliflozin 06010203 Other Antidiabetic Drugs
54265 CPRD_product_code Dapagliflozin 5mg tablets drug res50: SGLT-2 inhibitors Dapagliflozin 06010203 Other Antidiabetic Drugs
54480 CPRD_product_code Forxiga 5mg tablets (AstraZeneca UK Ltd) drug res50: SGLT-2 inhibitors Dapagliflozin 06010203 Other Antidiabetic Drugs
60012 CPRD_product_code Dapagliflozin 5mg / Metformin 1g tablets drug res50: SGLT-2 inhibitors Metformin hydrochloride/Dapagliflozin 06010202 Biguanides
60211 CPRD_product_code Canagliflozin 100mg tablets drug res50: SGLT-2 inhibitors Canagliflozin hemihydrate 06010203 Other Antidiabetic Drugs
60430 CPRD_product_code Invokana 100mg tablets (Janssen-Cilag Ltd) drug res50: SGLT-2 inhibitors Canagliflozin hemihydrate 06010203 Other Antidiabetic Drugs
60643 CPRD_product_code Xigduo 5mg/1000mg tablets (AstraZeneca UK Ltd) drug res50: SGLT-2 inhibitors Metformin hydrochloride/Dapagliflozin 06010202 Biguanides

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