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Severe Hypoglycemia as a Predictor of End-Stage Renal Disease in Type 2 Diabetes: A National Cohort Study

Author

Listed:
  • Yu-Li Lee

    (Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
    Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
    The authors contributed equally to this work.)

  • Shih-Jung Yen

    (Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
    Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
    The authors contributed equally to this work.)

  • Shyi-Jang Shin

    (Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
    College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan)

  • Yi-Chi Huang

    (Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan)

  • Jiun Shiuan He

    (Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
    Department of Public Health, Kaohsiung Medical University, Kaohsiung 80708, Taiwan)

  • Kun-Der Lin

    (Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
    Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
    College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan)

Abstract

Aims: This study investigated whether there is a link between severe hypoglycemia and progression into end-stage renal disease (ESRD) in patients with type 2 diabetes. Methods: Tapping into Taiwan’s Health Insurance Research Database, we identified all type 2 diabetes patients between 1996 and 2013 and identified those diagnosed with a severe hypoglycemia episode during an emergency department visit and those who were not. Controls were then matched 1:1 for age, sex, index year, and medication. Results: We identified 468,421 type 2 diabetes patients diagnosed as having severe hypoglycemia in an emergency department visit. Compared with controls, these patients with SH had a higher risk of all-cause mortality (Hazard Ratio (HR), 1.76; 95% confidence interval, 1.61–1.94) and progressed into ESRD within a shorter period of time. Results were similar after controlling for competing risk. Conclusion: Severe hypoglycemia is significantly associated with worsening renal dysfunction in patients with type 2 diabetes and hastened progression into ESRD.

Suggested Citation

  • Yu-Li Lee & Shih-Jung Yen & Shyi-Jang Shin & Yi-Chi Huang & Jiun Shiuan He & Kun-Der Lin, 2019. "Severe Hypoglycemia as a Predictor of End-Stage Renal Disease in Type 2 Diabetes: A National Cohort Study," IJERPH, MDPI, vol. 16(5), pages 1-8, February.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:5:p:681-:d:209061
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