PMID- 30425585
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220330
IS  - 1179-1349 (Print)
IS  - 1179-1349 (Electronic)
IS  - 1179-1349 (Linking)
VI  - 10
DP  - 2018
TI  - Development and validation of a risk prediction model for severe hypoglycemia in 
      adult patients with type 2 diabetes: a nationwide population-based cohort study.
PG  - 1545-1559
LID - 10.2147/CLEP.S169835 [doi]
AB  - PURPOSE: There is a scarcity of long-term prediction models for severe 
      hypoglycemia (SH) in subjects with type 2 diabetes mellitus (T2DM). In this 
      study, a model was developed and validated to predict the risk of SH in adult 
      patients with T2DM. PATIENTS AND METHODS: Baseline and follow-up data from 
      patients with T2DM who received health evaluations from January 1, 2009, to 
      December 31, 2010 (n=1,676,885) were analyzed as development (n=1,173,820) and 
      validation (n=503,065) cohorts using the National Health Insurance Database (DB) 
      in Korea. New SH episodes were identified using ICD-10 codes. A Cox proportional 
      hazards regression model and Cox model coefficients were used to derive a risk 
      scoring system, and 14 predictive variables were selected. A risk score nomogram 
      based on the risk prediction model was created to estimate the 1-year risk of SH. 
      RESULTS: In the development cohort, a total of 5,325 (0.45%) patients experienced 
      SH episodes during the follow-up period. After multivariable adjustment, older 
      age, female sex, current smoker, drinking, low body mass index, lack of exercise, 
      previous SH events, insulin or multiple oral hypoglycemic agent use, presence of 
      hypertension or chronic kidney disease, longer duration of diabetes, low or high 
      glucose level, and high Charlson Comorbidity Index score were found to be 
      significant risk factors for the development of SH and were incorporated into the 
      risk model. The concordance indices were 0.871 (95% confidence interval, 
      0.863-0.881) in development cohort and 0.866 (95% CI, 0.856-0.879) in the 
      validation cohort. The calibration plot showed a nearly 45 degrees  line, which indicates 
      that this model predicts well an absolute SH event. CONCLUSION: This 14-variable 
      prediction model for SH events may be a useful tool to identify high-risk 
      patients and guide prevention of SH in adult patients with T2DM.
FAU - Han, Kyungdo
AU  - Han K
AD  - Department of Biostatistics, The Catholic University of Korea, Seoul, Republic of 
      Korea.
FAU - Yun, Jae-Seung
AU  - Yun JS
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, St. 
      Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 
      Republic of Korea, kosh@catholic.ac.kr.
FAU - Park, Yong-Moon
AU  - Park YM
AD  - Epidemiology Branch, National Institute of Environmental Health Sciences, 
      National Institutes of Health, Research Triangle Park, NC, USA.
FAU - Ahn, Yu-Bae
AU  - Ahn YB
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, St. 
      Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 
      Republic of Korea, kosh@catholic.ac.kr.
FAU - Cho, Jae-Hyoung
AU  - Cho JH
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, St. 
      Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 
      Republic of Korea, kosh@catholic.ac.kr.
FAU - Cha, Seon-Ah
AU  - Cha SA
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, St. 
      Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 
      Republic of Korea, kosh@catholic.ac.kr.
FAU - Ko, Seung-Hyun
AU  - Ko SH
AD  - Division of Endocrinology and Metabolism, Department of Internal Medicine, St. 
      Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 
      Republic of Korea, kosh@catholic.ac.kr.
LA  - eng
PT  - Journal Article
DEP - 20181023
PL  - New Zealand
TA  - Clin Epidemiol
JT  - Clinical epidemiology
JID - 101531700
PMC - PMC6203120
OTO - NOTNLM
OT  - risk model
OT  - risk prediction
OT  - severe hypoglycemia
OT  - type 2 diabetes
COIS- Disclosure The authors report no conflicts of interest in this work.
EDAT- 2018/11/15 06:00
MHDA- 2018/11/15 06:01
PMCR- 2018/10/23
CRDT- 2018/11/15 06:00
PHST- 2018/11/15 06:00 [entrez]
PHST- 2018/11/15 06:00 [pubmed]
PHST- 2018/11/15 06:01 [medline]
PHST- 2018/10/23 00:00 [pmc-release]
AID - clep-10-1545 [pii]
AID - 10.2147/CLEP.S169835 [doi]
PST - epublish
SO  - Clin Epidemiol. 2018 Oct 23;10:1545-1559. doi: 10.2147/CLEP.S169835. eCollection 
      2018.