PMID- 35266273
OWN - NLM
STAT- MEDLINE
DCOM- 20220608
LR  - 20220731
IS  - 1463-1326 (Electronic)
IS  - 1462-8902 (Print)
IS  - 1462-8902 (Linking)
VI  - 24
IP  - 7
DP  - 2022 Jul
TI  - Previously unrecognized risk factors for severe hypoglycaemia requiring emergency 
      medical care in insulin-treated type 2 diabetes: Results from a real-world nested 
      case-control study.
PG  - 1235-1244
LID - 10.1111/dom.14690 [doi]
AB  - AIM: Several risk factors for severe hypoglycaemia (SH) are associated with 
      insulin-treated diabetes. This study explored potential risk factors in adults 
      with insulin-treated type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: In 
      this case-control study, adults with T2DM initiating insulin were identified in 
      the IQVIA PharMetrics(R) Plus database. The index date was the date of the first SH 
      event (cases). Using incidence-density sampling, controls were selected from 
      those who had been exposed 'at risk' of SH for the same amount of time as each 
      case. After exact-matching on the well-established factors, previously unreported 
      risk factors were evaluated through conditional logistic regression. RESULTS: In 
      3153 case-control pairs, pregnancy [odds ratios (OR) = 3.20, p = .0003], alcohol 
      abuse (OR = 2.43, p < .0001), short-/rapid-acting insulin (OR = 2.22/1.47, 
      p < .0001), cancer (OR = 1.87, p < .0001), dementia/Alzheimer's disease 
      (OR = 1.73, p = .0175), peripheral vascular disease (OR = 1.59, p < .0001), 
      antipsychotics (OR = 1.59; p = .0059), anxiolytics (OR = 1.51, p = .0012), 
      paralysis/hemiplegia/paraplegia (OR = 1.51, p = .0416), hepatitis (OR = 1.50, 
      p = .0303), congestive heart failure (OR = 1.47, p = .0002), 
      adrenergic-corticosteroid combinations (OR = 1.45, p = .0165), beta-adrenoceptor 
      agonists (OR = 1.40, p = .0225), opioids (OR = 1.38, p < .0001), corticosteroids 
      (OR = 1.35, p = .0159), cardiac arrhythmia (OR = 1.29. p = .0065), smoking 
      (OR = 1.28, p = .005), Charlson Comorbidity Index score 2 (OR = 1.28, p = .0026), 
      3 (OR = 1.41, p = .0016) or >/=4 (OR = 1.57, p = .0002), 
      liver/gallbladder/pancreatic disease (OR = 1.26, p = .0182) and hypertension 
      (OR = 1.19, p = .0164) were independently associated with SH. CONCLUSIONS: 
      Although all people with insulin-treated diabetes are at risk of SH, these 
      results have identified some previously unrecognized risk factors and sub-groups 
      of insulin-treated adults with T2DM at greater risk. Scrutiny of current 
      therapies and comorbidities are advised as well as additional glucose monitoring 
      and education, when identifying and managing SH in vulnerable populations.
CI  - (c) 2022 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & 
      Sons Ltd.
FAU - Settles, Julie
AU  - Settles J
AD  - Eli Lilly and Company Corporate Center, Indianapolis, Indiana, USA.
FAU - Kan, Hong
AU  - Kan H
AD  - Eli Lilly and Company Corporate Center, Indianapolis, Indiana, USA.
FAU - Child, Christopher J
AU  - Child CJ
AD  - Eli Lilly and Company Corporate Center, Indianapolis, Indiana, USA.
FAU - Gorritz, Magdaliz
AU  - Gorritz M
AUID- ORCID: 0000-0001-6806-3188
AD  - IQVIA Real-World Evidence Solutions, Plymouth Meeting, Plymouth, Pennsylvania, 
      USA.
FAU - Multani, Jasjit K
AU  - Multani JK
AD  - IQVIA Real-World Evidence Solutions, Plymouth Meeting, Plymouth, Pennsylvania, 
      USA.
FAU - McGuiness, Catherine B
AU  - McGuiness CB
AD  - IQVIA Real-World Evidence Solutions, Plymouth Meeting, Plymouth, Pennsylvania, 
      USA.
FAU - Wade, Rolin L
AU  - Wade RL
AD  - IQVIA Real-World Evidence Solutions, Plymouth Meeting, Plymouth, Pennsylvania, 
      USA.
FAU - Frier, Brian M
AU  - Frier BM
AD  - Centre for Cardiovascular Science, The Queen's Medical Research Institute, 
      University of Edinburgh, Edinburgh, UK.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220411
PL  - England
TA  - Diabetes Obes Metab
JT  - Diabetes, obesity & metabolism
JID - 100883645
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Insulin, Regular, Human)
SB  - IM
MH  - Adult
MH  - Blood Glucose
MH  - Blood Glucose Self-Monitoring
MH  - Case-Control Studies
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy/epidemiology
MH  - Humans
MH  - *Hypoglycemia/chemically induced/complications/epidemiology
MH  - Hypoglycemic Agents/adverse effects
MH  - Insulin/adverse effects
MH  - Insulin, Regular, Human
MH  - Risk Factors
PMC - PMC9322525
OTO - NOTNLM
OT  - insulin therapy
OT  - risk factors
OT  - severe hypoglycaemia
OT  - type 2 diabetes mellitus
COIS- The authors declare the following potential conflicts of interest with respect to 
      the research, authorship and/or publication of this article: HK, CJC and JAS are 
      full time employees of Eli Lilly and Company. CBMcG, JKM, RLW and MG are 
      full-time employees of IQVIA, which is a consulting company that has received 
      consulting fees from Eli Lilly and Company. BMF did not receive an honorarium for 
      any aspect of the manuscript development and submission; he participates in 
      speakers bureaus for Eli Lilly, Novo Nordisk, Abbott and the Worldwide Initiative 
      for Diabetes Education, and in advisory boards with Eli Lilly and Zucara 
      Pharmaceuticals.
EDAT- 2022/03/11 06:00
MHDA- 2022/06/09 06:00
PMCR- 2022/07/26
CRDT- 2022/03/10 05:50
PHST- 2022/02/24 00:00 [revised]
PHST- 2021/07/21 00:00 [received]
PHST- 2022/03/04 00:00 [accepted]
PHST- 2022/03/11 06:00 [pubmed]
PHST- 2022/06/09 06:00 [medline]
PHST- 2022/03/10 05:50 [entrez]
PHST- 2022/07/26 00:00 [pmc-release]
AID - DOM14690 [pii]
AID - 10.1111/dom.14690 [doi]
PST - ppublish
SO  - Diabetes Obes Metab. 2022 Jul;24(7):1235-1244. doi: 10.1111/dom.14690. Epub 2022 
      Apr 11.