Risk of hypoglycaemia in type 2 diabetes patients under different insulin regimens: a primary care database analysis
[english] Aims: To compare rates and predictors of documented hypoglycaemia in type 2 diabetes patients treated with either basal insulin supported oral therapy (BOT), conventional therapy (CT) or supplementary insulin therapy (SIT) in primary care.Methods: Data from 10,842 anonymous patients (mean...
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| Format: | Article |
| Language: | deu |
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German Medical Science GMS Publishing House
2015-01-01
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| Series: | GMS German Medical Science |
| Subjects: | |
| Online Access: | http://www.egms.de/static/en/journals/gms/2015-13/000205.shtml |
| _version_ | 1811286006919331840 |
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| author | Kostev, Karel Dippel, Franz W. Rathmann, Wolfgang |
| author_facet | Kostev, Karel Dippel, Franz W. Rathmann, Wolfgang |
| author_sort | Kostev, Karel |
| collection | DOAJ |
| description | [english] Aims: To compare rates and predictors of documented hypoglycaemia in type 2 diabetes patients treated with either basal insulin supported oral therapy (BOT), conventional therapy (CT) or supplementary insulin therapy (SIT) in primary care.Methods: Data from 10,842 anonymous patients (mean age ± SD: 54 ± 8 yrs) on BOT, 2,407 subjects (56 ± 7 yrs) on CT, and 7,480 patients (52 ± 10 yrs) using SIT from 1,198 primary care practices were retrospectively analyzed (Disease Analyzer, Germany: 01/2005–07/2013). Stepwise logistic regression (≥1 documented hypoglycaemia: ICD code) was used to evaluate risk factors of hypoglycemia. Results: The unadjusted rates (95% CI) per 100 patient-years of documented hypoglycaemia were 1.01 (0.80–1.20) (BOT), 1.68 (1.10–2.30) (CT), and 1.61 (1.30–1.90) (SIT), respectively. The odds of having was increased for CT (OR; 95% CI: 1.71; 1.13–2.58) and SIT (1.55; 1.15–2.08) (reference: BOT). Previous hypoglycemia (OR: 11.24; 6.71–18.85), duration of insulin treatment (days) (1.06; 1.05–1.07), history of transient ischemic attack (TIA)/stroke (1.91; 1.04–3.50), and former salicylate prescriptions (1.44; 1.06–1.98) also showed an increased odds of having hypoglycemia. Higher age was associated with a slightly lower odds ratio (per year: 0.98; 0.97–0.99).Conclusions: Insulin naïve type 2 diabetes patients in primary care, initiated with CT and SIT have an increased risk of hypoglycaemia compared to BOT, which is in line with previous randomized controlled trials. As hypoglycaemic events are associated with an increased mortality risk, this real-world finding is of clinical relevance. |
| first_indexed | 2024-04-13T02:53:18Z |
| format | Article |
| id | doaj.art-81570b4780704892bc3f18b930363a07 |
| institution | Directory Open Access Journal |
| issn | 1612-3174 |
| language | deu |
| last_indexed | 2024-04-13T02:53:18Z |
| publishDate | 2015-01-01 |
| publisher | German Medical Science GMS Publishing House |
| record_format | Article |
| series | GMS German Medical Science |
| spelling | doaj.art-81570b4780704892bc3f18b930363a072022-12-22T03:05:47ZdeuGerman Medical Science GMS Publishing HouseGMS German Medical Science1612-31742015-01-0113Doc0110.3205/000205Risk of hypoglycaemia in type 2 diabetes patients under different insulin regimens: a primary care database analysisKostev, Karel0Dippel, Franz W.1Rathmann, Wolfgang2IMS HEALTH, Frankfurt, GermanyDepartment of Internal Medicine, Neurology und Dermatology, University of Leipzig, GermanyInstitute of Biometrics and Epidemiology, German Diabetes Center, Duesseldorf, Germany[english] Aims: To compare rates and predictors of documented hypoglycaemia in type 2 diabetes patients treated with either basal insulin supported oral therapy (BOT), conventional therapy (CT) or supplementary insulin therapy (SIT) in primary care.Methods: Data from 10,842 anonymous patients (mean age ± SD: 54 ± 8 yrs) on BOT, 2,407 subjects (56 ± 7 yrs) on CT, and 7,480 patients (52 ± 10 yrs) using SIT from 1,198 primary care practices were retrospectively analyzed (Disease Analyzer, Germany: 01/2005–07/2013). Stepwise logistic regression (≥1 documented hypoglycaemia: ICD code) was used to evaluate risk factors of hypoglycemia. Results: The unadjusted rates (95% CI) per 100 patient-years of documented hypoglycaemia were 1.01 (0.80–1.20) (BOT), 1.68 (1.10–2.30) (CT), and 1.61 (1.30–1.90) (SIT), respectively. The odds of having was increased for CT (OR; 95% CI: 1.71; 1.13–2.58) and SIT (1.55; 1.15–2.08) (reference: BOT). Previous hypoglycemia (OR: 11.24; 6.71–18.85), duration of insulin treatment (days) (1.06; 1.05–1.07), history of transient ischemic attack (TIA)/stroke (1.91; 1.04–3.50), and former salicylate prescriptions (1.44; 1.06–1.98) also showed an increased odds of having hypoglycemia. Higher age was associated with a slightly lower odds ratio (per year: 0.98; 0.97–0.99).Conclusions: Insulin naïve type 2 diabetes patients in primary care, initiated with CT and SIT have an increased risk of hypoglycaemia compared to BOT, which is in line with previous randomized controlled trials. As hypoglycaemic events are associated with an increased mortality risk, this real-world finding is of clinical relevance.http://www.egms.de/static/en/journals/gms/2015-13/000205.shtmlinsulin therapytype 2 diabeteshypoglycaemiarisk factorsprimary care |
| spellingShingle | Kostev, Karel Dippel, Franz W. Rathmann, Wolfgang Risk of hypoglycaemia in type 2 diabetes patients under different insulin regimens: a primary care database analysis GMS German Medical Science insulin therapy type 2 diabetes hypoglycaemia risk factors primary care |
| title | Risk of hypoglycaemia in type 2 diabetes patients under different insulin regimens: a primary care database analysis |
| title_full | Risk of hypoglycaemia in type 2 diabetes patients under different insulin regimens: a primary care database analysis |
| title_fullStr | Risk of hypoglycaemia in type 2 diabetes patients under different insulin regimens: a primary care database analysis |
| title_full_unstemmed | Risk of hypoglycaemia in type 2 diabetes patients under different insulin regimens: a primary care database analysis |
| title_short | Risk of hypoglycaemia in type 2 diabetes patients under different insulin regimens: a primary care database analysis |
| title_sort | risk of hypoglycaemia in type 2 diabetes patients under different insulin regimens a primary care database analysis |
| topic | insulin therapy type 2 diabetes hypoglycaemia risk factors primary care |
| url | http://www.egms.de/static/en/journals/gms/2015-13/000205.shtml |
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