Nationwide reduction in the frequency of severe hypoglycemia by half
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Nationwide reduction in the frequency of severe hypoglycemia by half. / Fredheim, S.; Johansen, A.; Thorsen, S. U.; Kremke, B.; Nielsen, L. B.; Olsen, B. S.; Lyngsøe, L.; Sildorf, S. M.; Pipper, Christian Bressen; Mortensen, H. B.; Johannesen, J.; Svensson, J.
I: Acta Diabetologica, Bind 52, Nr. 3, 06.2015, s. 591-599.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Nationwide reduction in the frequency of severe hypoglycemia by half
AU - Fredheim, S.
AU - Johansen, A.
AU - Thorsen, S. U.
AU - Kremke, B.
AU - Nielsen, L. B.
AU - Olsen, B. S.
AU - Lyngsøe, L.
AU - Sildorf, S. M.
AU - Pipper, Christian Bressen
AU - Mortensen, H. B.
AU - Johannesen, J.
AU - Svensson, J.
PY - 2015/6
Y1 - 2015/6
N2 - Aims: To examine contemporary rates of severe hypoglycemia (SH) and identify the effect of predictors of SH in a pediatric type 1 diabetes population.Methods: The national diabetes register provided data on children residing in Denmark from 2008 to 2013 in this register-based population study. Robust Poisson regression models were applied.Results: The study population [n = 2,715 (50.9 % boys), mean (SD) age at onset; 8.1 (4.0) years, diabetes duration; 5.6 (4.9) years] comprised 7,390 person-years of data and 561 events of SH. The overall incidence of SH was 7.6 per 100 person-years. The incidence rate peaked with 16.0 per 100 person-years in 2008 reaching a nadir of 4.9 in 2011. Overall, insulin pump reduced the rate of SH with 27 % compared to any pen treatment (P = 0.003). When stratifying pen treatment, premixed insulin increased the rate of SH by 1.9-fold (P = 0.0015) and NPH increased the rate by 1.6-fold (P = 0.003) versus pump treatment, whereas long-acting insulin analogues were comparable with pump treatment (P = 0.1485). We found no association of SH with glycemic control (P > 0.05).Conclusions: A nationwide halving in rates of severe hypoglycemia was observed during the study period independent of the prevailing average HbA1c level. Changes in diabetes care and successful educational programs may have influenced the lower incidence rate of severe hypoglycemia.
AB - Aims: To examine contemporary rates of severe hypoglycemia (SH) and identify the effect of predictors of SH in a pediatric type 1 diabetes population.Methods: The national diabetes register provided data on children residing in Denmark from 2008 to 2013 in this register-based population study. Robust Poisson regression models were applied.Results: The study population [n = 2,715 (50.9 % boys), mean (SD) age at onset; 8.1 (4.0) years, diabetes duration; 5.6 (4.9) years] comprised 7,390 person-years of data and 561 events of SH. The overall incidence of SH was 7.6 per 100 person-years. The incidence rate peaked with 16.0 per 100 person-years in 2008 reaching a nadir of 4.9 in 2011. Overall, insulin pump reduced the rate of SH with 27 % compared to any pen treatment (P = 0.003). When stratifying pen treatment, premixed insulin increased the rate of SH by 1.9-fold (P = 0.0015) and NPH increased the rate by 1.6-fold (P = 0.003) versus pump treatment, whereas long-acting insulin analogues were comparable with pump treatment (P = 0.1485). We found no association of SH with glycemic control (P > 0.05).Conclusions: A nationwide halving in rates of severe hypoglycemia was observed during the study period independent of the prevailing average HbA1c level. Changes in diabetes care and successful educational programs may have influenced the lower incidence rate of severe hypoglycemia.
KW - Children
KW - Hypoglycemia
KW - Insulin therapy
KW - Register
KW - Type 1 diabetes
UR - https://www.scopus.com/record/display.uri?eid=2-s2.0-84930081623&origin=resultslist&sort=plf-f&src=s&st1=Nationwide+reduction+in+the+frequency+of+severe+hypoglycemia+by+half&st2=&sid=095E7B63AB04ACB9147B6682EE127391.euC1gMODexYlPkQec4u1Q%3a280&sot=b&sdt=b&sl=75&s=TITLE%28Nationwide+reduction+in+the+frequency+of+severe+hypoglycemia+by+half%29&relpos=0&citeCnt=3&searchTerm=
U2 - 10.1007/s00592-014-0697-5
DO - 10.1007/s00592-014-0697-5
M3 - Journal article
C2 - 25528006
VL - 52
SP - 591
EP - 599
JO - Acta Diabetologica
JF - Acta Diabetologica
SN - 0940-5429
IS - 3
ER -
ID: 131869122