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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: stroke
203 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 1477 | Read | H/O: cerebrovascular disease | diagnostic | res50: stroke | |||
| 14A7.00 | Read | H/O: CVA/stroke | diagnostic | res50: stroke | |||
| 14A7.11 | Read | H/O: CVA | diagnostic | res50: stroke | |||
| 14A7.12 | Read | H/O: stroke | diagnostic | res50: stroke | |||
| 14AB000 | Read | H/O amaurosis fugax | diagnostic | res50: stroke | |||
| 14AK.00 | Read | H/O: Stroke in last year | diagnostic | res50: stroke | |||
| 1M4..00 | Read | Central post-stroke pain | diagnostic | res50: stroke | |||
| 388I.00 | Read | Stroke risk | diagnostic | res50: stroke | |||
| C315100 | Read | Mitochond encephalopathy, lact acidosis & strokelike episode | diagnostic | res50: stroke | |||
| E030400 | Read | Acute confusional state, of cerebrovascular origin | diagnostic | res50: stroke | |||
| E031400 | Read | Subacute confusional state, of cerebrovascular origin | diagnostic | res50: stroke | |||
| F11x200 | Read | Cerebral degeneration due to cerebrovascular disease | diagnostic | res50: stroke | |||
| F137000 | Read | Athetoid cerebral palsy | diagnostic | res50: stroke | |||
| F137.11 | Read | Athetoid cerebral palsy | diagnostic | res50: stroke | |||
| F23..00 | Read | Congenital cerebral palsy | diagnostic | res50: stroke | |||
| F230100 | Read | Cerebral palsy with spastic diplegia | diagnostic | res50: stroke | |||
| F230111 | Read | Spastic diplegic cerebral palsy | diagnostic | res50: stroke | |||
| F23..11 | Read | Congenital spastic cerebral palsy | diagnostic | res50: stroke | |||
| F23..12 | Read | Infantile cerebral palsy | diagnostic | res50: stroke | |||
| F23y.00 | Read | Other congenital cerebral palsy | diagnostic | res50: stroke | |||
| F23y000 | Read | Ataxic infantile cerebral palsy | diagnostic | res50: stroke | |||
| F23y100 | Read | Flaccid infantile cerebral palsy | diagnostic | res50: stroke | |||
| F23y200 | Read | Spastic cerebral palsy | diagnostic | res50: stroke | |||
| F23y300 | Read | Dyskinetic cerebral palsy | diagnostic | res50: stroke | |||
| F23y400 | Read | Ataxic diplegic cerebral palsy | diagnostic | res50: stroke | |||
| F23y600 | Read | Choreoathetoid cerebral palsy | diagnostic | res50: stroke | |||
| F23yz00 | Read | Other infantile cerebral palsy NOS | diagnostic | res50: stroke | |||
| F23z.00 | Read | Congenital cerebral palsy NOS | diagnostic | res50: stroke | |||
| F2B..00 | Read | Cerebral palsy | diagnostic | res50: stroke | |||
| F2B0.00 | Read | Spastic quadriplegic cerebral palsy | diagnostic | res50: stroke | |||
| F2B1.00 | Read | Spastic hemiplegic cerebral palsy | diagnostic | res50: stroke | |||
| F2By.00 | Read | Other cerebral palsy | diagnostic | res50: stroke | |||
| F2Bz.00 | Read | Cerebral palsy NOS | diagnostic | res50: stroke | |||
| F423100 | Read | Central retinal artery occlusion | diagnostic | res50: stroke | |||
| F423211 | Read | Branch retinal artery occlusion | diagnostic | res50: stroke | |||
| F423500 | Read | Retinal partial arterial occlusion NOS | diagnostic | res50: stroke | |||
| F423600 | Read | Amaurosis fugax | diagnostic | res50: stroke | |||
| F423700 | Read | Retinal transient arterial occlusion NOS | diagnostic | res50: stroke | |||
| Fyu5500 | Read | [X]Other transnt cerebral ischaemic attacks+related syndroms | diagnostic | res50: stroke | |||
| Fyu5600 | Read | [X]Other lacunar syndromes | diagnostic | res50: stroke | |||
| Fyu9.00 | Read | [X]Cerebral palsy and other paralytic syndromes | diagnostic | res50: stroke | |||
| Fyu9000 | Read | [X]Other infantile cerebral palsy | diagnostic | res50: stroke | |||
| FyuF500 | Read | [X]Other retinal artery occlusions | diagnostic | res50: stroke | |||
| G6...00 | Read | Cerebrovascular disease | diagnostic | res50: stroke | |||
| G60..00 | Read | Subarachnoid haemorrhage | diagnostic | res50: stroke | |||
| G600.00 | Read | Ruptured berry aneurysm | diagnostic | res50: stroke | |||
| G601.00 | Read | Subarachnoid haemorrhage from carotid siphon and bifurcation | diagnostic | res50: stroke | |||
| G602.00 | Read | Subarachnoid haemorrhage from middle cerebral artery | diagnostic | res50: stroke | |||
| G603.00 | Read | Subarachnoid haemorrhage from anterior communicating artery | diagnostic | res50: stroke | |||
| G604.00 | Read | Subarachnoid haemorrhage from posterior communicating artery | diagnostic | res50: stroke | |||
| G605.00 | Read | Subarachnoid haemorrhage from basilar artery | diagnostic | res50: stroke | |||
| G606.00 | Read | Subarachnoid haemorrhage from vertebral artery | diagnostic | res50: stroke | |||
| G60X.00 | Read | Subarachnoid haemorrh from intracranial artery, unspecif | diagnostic | res50: stroke | |||
| G60z.00 | Read | Subarachnoid haemorrhage NOS | diagnostic | res50: stroke | |||
| G61..00 | Read | Intracerebral haemorrhage | diagnostic | res50: stroke | |||
| G610.00 | Read | Cortical haemorrhage | diagnostic | res50: stroke | |||
| G61..11 | Read | CVA - cerebrovascular accid due to intracerebral haemorrhage | diagnostic | res50: stroke | |||
| G61..12 | Read | Stroke due to intracerebral haemorrhage | diagnostic | res50: stroke | |||
| G612.00 | Read | Basal nucleus haemorrhage | diagnostic | res50: stroke | |||
| G613.00 | Read | Cerebellar haemorrhage | diagnostic | res50: stroke | |||
| G614.00 | Read | Pontine haemorrhage | diagnostic | res50: stroke | |||
| G615.00 | Read | Bulbar haemorrhage | diagnostic | res50: stroke | |||
| G616.00 | Read | External capsule haemorrhage | diagnostic | res50: stroke | |||
| G617.00 | Read | Intracerebral haemorrhage, intraventricular | diagnostic | res50: stroke | |||
| G618.00 | Read | Intracerebral haemorrhage, multiple localized | diagnostic | res50: stroke | |||
| G61X.00 | Read | Intracerebral haemorrhage in hemisphere, unspecified | diagnostic | res50: stroke | |||
| G61X000 | Read | Left sided intracerebral haemorrhage, unspecified | diagnostic | res50: stroke | |||
| G61X100 | Read | Right sided intracerebral haemorrhage, unspecified | diagnostic | res50: stroke | |||
| G61z.00 | Read | Intracerebral haemorrhage NOS | diagnostic | res50: stroke | |||
| G62..00 | Read | Other and unspecified intracranial haemorrhage | diagnostic | res50: stroke | |||
| G621.00 | Read | Subdural haemorrhage - nontraumatic | diagnostic | res50: stroke | |||
| G623.00 | Read | Subdural haemorrhage NOS | diagnostic | res50: stroke | |||
| G62z.00 | Read | Intracranial haemorrhage NOS | diagnostic | res50: stroke | |||
| G63..00 | Read | Precerebral arterial occlusion | diagnostic | res50: stroke | |||
| G630.00 | Read | Basilar artery occlusion | diagnostic | res50: stroke | |||
| G631.00 | Read | Carotid artery occlusion | diagnostic | res50: stroke | |||
| G63..11 | Read | Infarction - precerebral | diagnostic | res50: stroke | |||
| G63..12 | Read | Stenosis of precerebral arteries | diagnostic | res50: stroke | |||
| G632.00 | Read | Vertebral artery occlusion | diagnostic | res50: stroke | |||
| G633.00 | Read | Multiple and bilateral precerebral arterial occlusion | diagnostic | res50: stroke | |||
| G63y.00 | Read | Other precerebral artery occlusion | diagnostic | res50: stroke | |||
| G63y000 | Read | Cerebral infarct due to thrombosis of precerebral arteries | diagnostic | res50: stroke | |||
| G63y100 | Read | Cerebral infarction due to embolism of precerebral arteries | diagnostic | res50: stroke | |||
| G63z.00 | Read | Precerebral artery occlusion NOS | diagnostic | res50: stroke | |||
| G64..00 | Read | Cerebral arterial occlusion | diagnostic | res50: stroke | |||
| G640.00 | Read | Cerebral thrombosis | diagnostic | res50: stroke | |||
| G640000 | Read | Cerebral infarction due to thrombosis of cerebral arteries | diagnostic | res50: stroke | |||
| G641.00 | Read | Cerebral embolism | diagnostic | res50: stroke | |||
| G641000 | Read | Cerebral infarction due to embolism of cerebral arteries | diagnostic | res50: stroke | |||
| G64..11 | Read | CVA - cerebral artery occlusion | diagnostic | res50: stroke | |||
| G641.11 | Read | Cerebral embolus | diagnostic | res50: stroke | |||
| G64..12 | Read | Infarction - cerebral | diagnostic | res50: stroke | |||
| G64..13 | Read | Stroke due to cerebral arterial occlusion | diagnostic | res50: stroke | |||
| G64z.00 | Read | Cerebral infarction NOS | diagnostic | res50: stroke | |||
| G64z000 | Read | Brainstem infarction | diagnostic | res50: stroke | |||
| G64z100 | Read | Wallenberg syndrome | diagnostic | res50: stroke | |||
| G64z.11 | Read | Brainstem infarction NOS | diagnostic | res50: stroke | |||
| G64z111 | Read | Lateral medullary syndrome | diagnostic | res50: stroke | |||
| G64z.12 | Read | Cerebellar infarction | diagnostic | res50: stroke | |||
| G64z200 | Read | Left sided cerebral infarction | diagnostic | res50: stroke | |||
| G64z300 | Read | Right sided cerebral infarction | diagnostic | res50: stroke | |||
| G64z400 | Read | Infarction of basal ganglia | diagnostic | res50: stroke | |||
| G65..00 | Read | Transient cerebral ischaemia | diagnostic | res50: stroke | |||
| G650.00 | Read | Basilar artery syndrome | diagnostic | res50: stroke | |||
| G650.11 | Read | Insufficiency - basilar artery | diagnostic | res50: stroke | |||
| G651.00 | Read | Vertebral artery syndrome | diagnostic | res50: stroke | |||
| G651000 | Read | Vertebro-basilar artery syndrome | diagnostic | res50: stroke | |||
| G65..11 | Read | Drop attack | diagnostic | res50: stroke | |||
| G65..12 | Read | Transient ischaemic attack | diagnostic | res50: stroke | |||
| G65..13 | Read | Vertebro-basilar insufficiency | diagnostic | res50: stroke | |||
| G652.00 | Read | Subclavian steal syndrome | diagnostic | res50: stroke | |||
| G653.00 | Read | Carotid artery syndrome hemispheric | diagnostic | res50: stroke | |||
| G654.00 | Read | Multiple and bilateral precerebral artery syndromes | diagnostic | res50: stroke | |||
| G656.00 | Read | Vertebrobasilar insufficiency | diagnostic | res50: stroke | |||
| G657.00 | Read | Carotid territory transient ischaemic attack | diagnostic | res50: stroke | |||
| G65y.00 | Read | Other transient cerebral ischaemia | diagnostic | res50: stroke | |||
| G65z.00 | Read | Transient cerebral ischaemia NOS | diagnostic | res50: stroke | |||
| G65z000 | Read | Impending cerebral ischaemia | diagnostic | res50: stroke | |||
| G65z100 | Read | Intermittent cerebral ischaemia | diagnostic | res50: stroke | |||
| G65zz00 | Read | Transient cerebral ischaemia NOS | diagnostic | res50: stroke | |||
| G66..00 | Read | Stroke and cerebrovascular accident unspecified | diagnostic | res50: stroke | |||
| G660.00 | Read | Middle cerebral artery syndrome | diagnostic | res50: stroke | |||
| G661.00 | Read | Anterior cerebral artery syndrome | diagnostic | res50: stroke | |||
| G66..11 | Read | CVA unspecified | diagnostic | res50: stroke | |||
| G66..12 | Read | Stroke unspecified | diagnostic | res50: stroke | |||
| G66..13 | Read | CVA - Cerebrovascular accident unspecified | diagnostic | res50: stroke | |||
| G662.00 | Read | Posterior cerebral artery syndrome | diagnostic | res50: stroke | |||
| G663.00 | Read | Brain stem stroke syndrome | diagnostic | res50: stroke | |||
| G664.00 | Read | Cerebellar stroke syndrome | diagnostic | res50: stroke | |||
| G665.00 | Read | Pure motor lacunar syndrome | diagnostic | res50: stroke | |||
| G666.00 | Read | Pure sensory lacunar syndrome | diagnostic | res50: stroke | |||
| G667.00 | Read | Left sided CVA | diagnostic | res50: stroke | |||
| G668.00 | Read | Right sided CVA | diagnostic | res50: stroke | |||
| G669.00 | Read | Cerebral palsy, not congenital or infantile, acute | diagnostic | res50: stroke | |||
| G67..00 | Read | Other cerebrovascular disease | diagnostic | res50: stroke | |||
| G671.00 | Read | Generalised ischaemic cerebrovascular disease NOS | diagnostic | res50: stroke | |||
| G671000 | Read | Acute cerebrovascular insufficiency NOS | diagnostic | res50: stroke | |||
| G671100 | Read | Chronic cerebral ischaemia | diagnostic | res50: stroke | |||
| G671z00 | Read | Generalised ischaemic cerebrovascular disease NOS | diagnostic | res50: stroke | |||
| G676000 | Read | Cereb infarct due cerebral venous thrombosis, nonpyogenic | diagnostic | res50: stroke | |||
| G677000 | Read | Occlusion and stenosis of middle cerebral artery | diagnostic | res50: stroke | |||
| G677100 | Read | Occlusion and stenosis of anterior cerebral artery | diagnostic | res50: stroke | |||
| G677200 | Read | Occlusion and stenosis of posterior cerebral artery | diagnostic | res50: stroke | |||
| G677300 | Read | Occlusion and stenosis of cerebellar arteries | diagnostic | res50: stroke | |||
| G677400 | Read | Occlusion+stenosis of multiple and bilat cerebral arteries | diagnostic | res50: stroke | |||
| G679.00 | Read | Small vessel cerebrovascular disease | diagnostic | res50: stroke | |||
| G67y.00 | Read | Other cerebrovascular disease OS | diagnostic | res50: stroke | |||
| G67z.00 | Read | Other cerebrovascular disease NOS | diagnostic | res50: stroke | |||
| G68..00 | Read | Late effects of cerebrovascular disease | diagnostic | res50: stroke | |||
| G680.00 | Read | Sequelae of subarachnoid haemorrhage | diagnostic | res50: stroke | |||
| G681.00 | Read | Sequelae of intracerebral haemorrhage | diagnostic | res50: stroke | |||
| G682.00 | Read | Sequelae of other nontraumatic intracranial haemorrhage | diagnostic | res50: stroke | |||
| G683.00 | Read | Sequelae of cerebral infarction | diagnostic | res50: stroke | |||
| G68W.00 | Read | Sequelae/other + unspecified cerebrovascular diseases | diagnostic | res50: stroke | |||
| G68X.00 | Read | Sequelae of stroke,not specfd as h'morrhage or infarction | diagnostic | res50: stroke | |||
| G6W..00 | Read | Cereb infarct due unsp occlus/stenos precerebr arteries | diagnostic | res50: stroke | |||
| G6X..00 | Read | Cerebrl infarctn due/unspcf occlusn or sten/cerebrl artrs | diagnostic | res50: stroke | |||
| G6y..00 | Read | Other specified cerebrovascular disease | diagnostic | res50: stroke | |||
| G6z..00 | Read | Cerebrovascular disease NOS | diagnostic | res50: stroke | |||
| G76z000 | Read | Iliac artery occlusion | diagnostic | res50: stroke | |||
| G76z100 | Read | Femoral artery occlusion | diagnostic | res50: stroke | |||
| G76z200 | Read | Popliteal artery occlusion | diagnostic | res50: stroke | |||
| Gyu6.00 | Read | [X]Cerebrovascular diseases | diagnostic | res50: stroke | |||
| Gyu6000 | Read | [X]Subarachnoid haemorrhage from other intracranial arteries | diagnostic | res50: stroke | |||
| Gyu6100 | Read | [X]Other subarachnoid haemorrhage | diagnostic | res50: stroke | |||
| Gyu6200 | Read | [X]Other intracerebral haemorrhage | diagnostic | res50: stroke | |||
| Gyu6300 | Read | [X]Cerebrl infarctn due/unspcf occlusn or sten/cerebrl artrs | diagnostic | res50: stroke | |||
| Gyu6400 | Read | [X]Other cerebral infarction | diagnostic | res50: stroke | |||
| Gyu6500 | Read | [X]Occlusion and stenosis of other precerebral arteries | diagnostic | res50: stroke | |||
| Gyu6600 | Read | [X]Occlusion and stenosis of other cerebral arteries | diagnostic | res50: stroke | |||
| Gyu6A00 | Read | [X]Other cerebrovascular disorders in diseases CE | diagnostic | res50: stroke | |||
| Gyu6E00 | Read | [X]Subarachnoid haemorrh from intracranial artery, unspecif | diagnostic | res50: stroke | |||
| Gyu6F00 | Read | [X]Intracerebral haemorrhage in hemisphere, unspecified | diagnostic | res50: stroke | |||
| Gyu6G00 | Read | [X]Cereb infarct due unsp occlus/stenos precerebr arteries | diagnostic | res50: stroke | |||
| J421000 | Read | Superior mesenteric artery syndrome | diagnostic | res50: stroke | |||
| L440.00 | Read | Cerebrovascular disorders in the puerperium | diagnostic | res50: stroke | |||
| L440000 | Read | Puerperal cerebrovascular disorder unspecified | diagnostic | res50: stroke | |||
| L440100 | Read | Puerperal cerebrovascular disorder - delivered | diagnostic | res50: stroke | |||
| L440.11 | Read | CVA - cerebrovascular accident in the puerperium | diagnostic | res50: stroke | |||
| L440.12 | Read | Stroke in the puerperium | diagnostic | res50: stroke | |||
| L440300 | Read | Puerperal cerebrovascular disorder with antenatal comp | diagnostic | res50: stroke | |||
| P7y0.00 | Read | Cerebrovascular system anomalies | diagnostic | res50: stroke | |||
| P7y0y00 | Read | Other specified cerebrovascular anomaly | diagnostic | res50: stroke | |||
| P7y0z00 | Read | Cerebrovascular system anomaly NOS | diagnostic | res50: stroke | |||
| Q200011 | Read | Intracerebral haemorrhage in fetus or newborn | diagnostic | res50: stroke | |||
| Q200012 | Read | Intracranial haemorrhage in fetus or newborn | diagnostic | res50: stroke | |||
| Q200100 | Read | Subdural haemorrhage unspecified, due to birth trauma | diagnostic | res50: stroke | |||
| Q412.00 | Read | Perinatal subarachnoid haemorrhage | diagnostic | res50: stroke | |||
| Q412000 | Read | Subarachnoid haemorrhage due to birth injury | diagnostic | res50: stroke | |||
| Q488.00 | Read | Neonatal cerebral ischaemia | diagnostic | res50: stroke | |||
| R002700 | Read | [D]Drop attack | diagnostic | res50: stroke | |||
| S620.00 | Read | Closed traumatic subarachnoid haemorrhage | diagnostic | res50: stroke | |||
| S621.00 | Read | Open traumatic subarachnoid haemorrhage | diagnostic | res50: stroke | |||
| S62..12 | Read | Subarachnoid haemorrhage following injury | diagnostic | res50: stroke | |||
| S62..13 | Read | Subdural haemorrhage following injury | diagnostic | res50: stroke | |||
| S622.00 | Read | Closed traumatic subdural haemorrhage | diagnostic | res50: stroke | |||
| S623.00 | Read | Open traumatic subdural haemorrhage | diagnostic | res50: stroke | |||
| S627.00 | Read | Traumatic subarachnoid haemorrhage | diagnostic | res50: stroke | |||
| S628.00 | Read | Traumatic subdural haemorrhage | diagnostic | res50: stroke | |||
| SN20000 | Read | Heat stroke, unspecified | diagnostic | res50: stroke | |||
| ZV12511 | Read | [V]Personal history of stroke | diagnostic | res50: stroke | |||
| ZV12512 | Read | [V]Personal history of cerebrovascular accident (CVA) | diagnostic | res50: stroke | |||
| ZV12D00 | Read | [V]Personal history of transient ischaemic attack | diagnostic | res50: stroke |
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