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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: type 1 diabetes

124 codes in list

Code Coding system Description Entity type List name
66An.00 Read Diabetes type 1 review diagnostic res50: type 1 diabetes
66At000 Read Type I diabetic dietary review diagnostic res50: type 1 diabetes
66At011 Read Type 1 diabetic dietary review diagnostic res50: type 1 diabetes
C100000 Read Diabetes mellitus, juvenile type, no mention of complication diagnostic res50: type 1 diabetes
C100011 Read Insulin dependent diabetes mellitus diagnostic res50: type 1 diabetes
C101000 Read Diabetes mellitus, juvenile type, with ketoacidosis diagnostic res50: type 1 diabetes
C102000 Read Diabetes mellitus, juvenile type, with hyperosmolar coma diagnostic res50: type 1 diabetes
C103000 Read Diabetes mellitus, juvenile type, with ketoacidotic coma diagnostic res50: type 1 diabetes
C104000 Read Diabetes mellitus, juvenile type, with renal manifestation diagnostic res50: type 1 diabetes
C105000 Read Diabetes mellitus, juvenile type, + ophthalmic manifestation diagnostic res50: type 1 diabetes
C106000 Read Diabetes mellitus, juvenile, + neurological manifestation diagnostic res50: type 1 diabetes
C107000 Read Diabetes mellitus, juvenile +peripheral circulatory disorder diagnostic res50: type 1 diabetes
C107300 Read IDDM with peripheral circulatory disorder diagnostic res50: type 1 diabetes
C108.00 Read Insulin dependent diabetes mellitus diagnostic res50: type 1 diabetes
C108000 Read Insulin-dependent diabetes mellitus with renal complications diagnostic res50: type 1 diabetes
C108011 Read Type I diabetes mellitus with renal complications diagnostic res50: type 1 diabetes
C108012 Read Type 1 diabetes mellitus with renal complications diagnostic res50: type 1 diabetes
C108100 Read Insulin-dependent diabetes mellitus with ophthalmic comps diagnostic res50: type 1 diabetes
C108.11 Read IDDM-Insulin dependent diabetes mellitus diagnostic res50: type 1 diabetes
C108112 Read Type 1 diabetes mellitus with ophthalmic complications diagnostic res50: type 1 diabetes
C108.12 Read Type 1 diabetes mellitus diagnostic res50: type 1 diabetes
C108.13 Read Type I diabetes mellitus diagnostic res50: type 1 diabetes
C108200 Read Insulin-dependent diabetes mellitus with neurological comps diagnostic res50: type 1 diabetes
C108211 Read Type I diabetes mellitus with neurological complications diagnostic res50: type 1 diabetes
C108212 Read Type 1 diabetes mellitus with neurological complications diagnostic res50: type 1 diabetes
C108300 Read Insulin dependent diabetes mellitus with multiple complicatn diagnostic res50: type 1 diabetes
C108311 Read Type I diabetes mellitus with multiple complications diagnostic res50: type 1 diabetes
C108400 Read Unstable insulin dependent diabetes mellitus diagnostic res50: type 1 diabetes
C108411 Read Unstable type I diabetes mellitus diagnostic res50: type 1 diabetes
C108412 Read Unstable type 1 diabetes mellitus diagnostic res50: type 1 diabetes
C108500 Read Insulin dependent diabetes mellitus with ulcer diagnostic res50: type 1 diabetes
C108511 Read Type I diabetes mellitus with ulcer diagnostic res50: type 1 diabetes
C108512 Read Type 1 diabetes mellitus with ulcer diagnostic res50: type 1 diabetes
C108600 Read Insulin dependent diabetes mellitus with gangrene diagnostic res50: type 1 diabetes
C108700 Read Insulin dependent diabetes mellitus with retinopathy diagnostic res50: type 1 diabetes
C108711 Read Type I diabetes mellitus with retinopathy diagnostic res50: type 1 diabetes
C108712 Read Type 1 diabetes mellitus with retinopathy diagnostic res50: type 1 diabetes
C108800 Read Insulin dependent diabetes mellitus - poor control diagnostic res50: type 1 diabetes
C108811 Read Type I diabetes mellitus - poor control diagnostic res50: type 1 diabetes
C108812 Read Type 1 diabetes mellitus - poor control diagnostic res50: type 1 diabetes
C108900 Read Insulin dependent diabetes maturity onset diagnostic res50: type 1 diabetes
C108911 Read Type I diabetes mellitus maturity onset diagnostic res50: type 1 diabetes
C108912 Read Type 1 diabetes mellitus maturity onset diagnostic res50: type 1 diabetes
C108A00 Read Insulin-dependent diabetes without complication diagnostic res50: type 1 diabetes
C108A11 Read Type I diabetes mellitus without complication diagnostic res50: type 1 diabetes
C108B00 Read Insulin dependent diabetes mellitus with mononeuropathy diagnostic res50: type 1 diabetes
C108B11 Read Type I diabetes mellitus with mononeuropathy diagnostic res50: type 1 diabetes
C108C00 Read Insulin dependent diabetes mellitus with polyneuropathy diagnostic res50: type 1 diabetes
C108D00 Read Insulin dependent diabetes mellitus with nephropathy diagnostic res50: type 1 diabetes
C108D11 Read Type I diabetes mellitus with nephropathy diagnostic res50: type 1 diabetes
C108E00 Read Insulin dependent diabetes mellitus with hypoglycaemic coma diagnostic res50: type 1 diabetes
C108E11 Read Type I diabetes mellitus with hypoglycaemic coma diagnostic res50: type 1 diabetes
C108E12 Read Type 1 diabetes mellitus with hypoglycaemic coma diagnostic res50: type 1 diabetes
C108F00 Read Insulin dependent diabetes mellitus with diabetic cataract diagnostic res50: type 1 diabetes
C108F11 Read Type I diabetes mellitus with diabetic cataract diagnostic res50: type 1 diabetes
C108G00 Read Insulin dependent diab mell with peripheral angiopathy diagnostic res50: type 1 diabetes
C108H00 Read Insulin dependent diabetes mellitus with arthropathy diagnostic res50: type 1 diabetes
C108H11 Read Type I diabetes mellitus with arthropathy diagnostic res50: type 1 diabetes
C108J00 Read Insulin dependent diab mell with neuropathic arthropathy diagnostic res50: type 1 diabetes
C108J11 Read Type I diabetes mellitus with neuropathic arthropathy diagnostic res50: type 1 diabetes
C108J12 Read Type 1 diabetes mellitus with neuropathic arthropathy diagnostic res50: type 1 diabetes
C10E.00 Read Type 1 diabetes mellitus diagnostic res50: type 1 diabetes
C10E000 Read Type 1 diabetes mellitus with renal complications diagnostic res50: type 1 diabetes
C10E012 Read Insulin-dependent diabetes mellitus with renal complications diagnostic res50: type 1 diabetes
C10E100 Read Type 1 diabetes mellitus with ophthalmic complications diagnostic res50: type 1 diabetes
C10E.11 Read Type I diabetes mellitus diagnostic res50: type 1 diabetes
C10E111 Read Type I diabetes mellitus with ophthalmic complications diagnostic res50: type 1 diabetes
C10E112 Read Insulin-dependent diabetes mellitus with ophthalmic comps diagnostic res50: type 1 diabetes
C10E.12 Read Insulin dependent diabetes mellitus diagnostic res50: type 1 diabetes
C10E200 Read Type 1 diabetes mellitus with neurological complications diagnostic res50: type 1 diabetes
C10E212 Read Insulin-dependent diabetes mellitus with neurological comps diagnostic res50: type 1 diabetes
C10E300 Read Type 1 diabetes mellitus with multiple complications diagnostic res50: type 1 diabetes
C10E311 Read Type I diabetes mellitus with multiple complications diagnostic res50: type 1 diabetes
C10E312 Read Insulin dependent diabetes mellitus with multiple complicat diagnostic res50: type 1 diabetes
C10E400 Read Unstable type 1 diabetes mellitus diagnostic res50: type 1 diabetes
C10E411 Read Unstable type I diabetes mellitus diagnostic res50: type 1 diabetes
C10E412 Read Unstable insulin dependent diabetes mellitus diagnostic res50: type 1 diabetes
C10E500 Read Type 1 diabetes mellitus with ulcer diagnostic res50: type 1 diabetes
C10E511 Read Type I diabetes mellitus with ulcer diagnostic res50: type 1 diabetes
C10E512 Read Insulin dependent diabetes mellitus with ulcer diagnostic res50: type 1 diabetes
C10E600 Read Type 1 diabetes mellitus with gangrene diagnostic res50: type 1 diabetes
C10E611 Read Type I diabetes mellitus with gangrene diagnostic res50: type 1 diabetes
C10E612 Read Insulin dependent diabetes mellitus with gangrene diagnostic res50: type 1 diabetes
C10E700 Read Type 1 diabetes mellitus with retinopathy diagnostic res50: type 1 diabetes
C10E711 Read Type I diabetes mellitus with retinopathy diagnostic res50: type 1 diabetes
C10E712 Read Insulin dependent diabetes mellitus with retinopathy diagnostic res50: type 1 diabetes
C10E800 Read Type 1 diabetes mellitus - poor control diagnostic res50: type 1 diabetes
C10E811 Read Type I diabetes mellitus - poor control diagnostic res50: type 1 diabetes
C10E812 Read Insulin dependent diabetes mellitus - poor control diagnostic res50: type 1 diabetes
C10E900 Read Type 1 diabetes mellitus maturity onset diagnostic res50: type 1 diabetes
C10E911 Read Type I diabetes mellitus maturity onset diagnostic res50: type 1 diabetes
C10E912 Read Insulin dependent diabetes maturity onset diagnostic res50: type 1 diabetes
C10EA00 Read Type 1 diabetes mellitus without complication diagnostic res50: type 1 diabetes
C10EA11 Read Type I diabetes mellitus without complication diagnostic res50: type 1 diabetes
C10EA12 Read Insulin-dependent diabetes without complication diagnostic res50: type 1 diabetes
C10EB00 Read Type 1 diabetes mellitus with mononeuropathy diagnostic res50: type 1 diabetes
C10EC00 Read Type 1 diabetes mellitus with polyneuropathy diagnostic res50: type 1 diabetes
C10EC11 Read Type I diabetes mellitus with polyneuropathy diagnostic res50: type 1 diabetes
C10EC12 Read Insulin dependent diabetes mellitus with polyneuropathy diagnostic res50: type 1 diabetes
C10ED00 Read Type 1 diabetes mellitus with nephropathy diagnostic res50: type 1 diabetes
C10ED12 Read Insulin dependent diabetes mellitus with nephropathy diagnostic res50: type 1 diabetes
C10EE00 Read Type 1 diabetes mellitus with hypoglycaemic coma diagnostic res50: type 1 diabetes
C10EE12 Read Insulin dependent diabetes mellitus with hypoglycaemic coma diagnostic res50: type 1 diabetes
C10EF00 Read Type 1 diabetes mellitus with diabetic cataract diagnostic res50: type 1 diabetes
C10EF12 Read Insulin dependent diabetes mellitus with diabetic cataract diagnostic res50: type 1 diabetes
C10EG00 Read Type 1 diabetes mellitus with peripheral angiopathy diagnostic res50: type 1 diabetes
C10EH00 Read Type 1 diabetes mellitus with arthropathy diagnostic res50: type 1 diabetes
C10EJ00 Read Type 1 diabetes mellitus with neuropathic arthropathy diagnostic res50: type 1 diabetes
C10EK00 Read Type 1 diabetes mellitus with persistent proteinuria diagnostic res50: type 1 diabetes
C10EL00 Read Type 1 diabetes mellitus with persistent microalbuminuria diagnostic res50: type 1 diabetes
C10EL11 Read Type I diabetes mellitus with persistent microalbuminuria diagnostic res50: type 1 diabetes
C10EM00 Read Type 1 diabetes mellitus with ketoacidosis diagnostic res50: type 1 diabetes
C10EM11 Read Type I diabetes mellitus with ketoacidosis diagnostic res50: type 1 diabetes
C10EN00 Read Type 1 diabetes mellitus with ketoacidotic coma diagnostic res50: type 1 diabetes
C10EN11 Read Type I diabetes mellitus with ketoacidotic coma diagnostic res50: type 1 diabetes
C10EP00 Read Type 1 diabetes mellitus with exudative maculopathy diagnostic res50: type 1 diabetes
C10EP11 Read Type I diabetes mellitus with exudative maculopathy diagnostic res50: type 1 diabetes
C10EQ00 Read Type 1 diabetes mellitus with gastroparesis diagnostic res50: type 1 diabetes
C10EQ11 Read Type I diabetes mellitus with gastroparesis diagnostic res50: type 1 diabetes
C10P000 Read Type I diabetes mellitus in remission diagnostic res50: type 1 diabetes
C10z000 Read Diabetes mellitus, juvenile type, + unspecified complication diagnostic res50: type 1 diabetes
L180500 Read Pre-existing diabetes mellitus, insulin-dependent diagnostic res50: type 1 diabetes
ZC2C900 Read Dietary advice for type I diabetes diagnostic res50: type 1 diabetes
ZRbH.00 Read Perceived control of insulin-dependent diabetes diagnostic res50: type 1 diabetes

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