Association of severe hypoglycemia with all-cause mortality and complication risks among patients with type 2 diabetes mellitus in China

Abstract

Aims: To investigate the association of severe hypoglycemia (SH) with all-cause mortality and complication risks among Chinese patients with type 2 diabetes mellitus (T2DM).

Methods: Cohort study and nested case-control studies were conducted based on medical insurance database 2008-2015. The incidence of outcomes or the exposure of previous SH was compared among matched patients, respectively. The association between SH and outcomes was investigated and validated by different models.

Results: Among cohort study participants (mean age of 59.0 ± 11.2 years), SH was associated with higher risk of all-cause mortality (HR = 1.80, P < 0.001) and transient ischemic attacks (TIA, HR = 1.51, P < 0.001), while no association was observed between SH and complications including myocardial infarction (MI), angina, arrhythmia and stroke. Similarly, SH was associated with about doubled all-cause mortality (OR = 1.76, P < 0.001) and TIA (OR = 2.00, P < 0.001), but not associated with risk of MI or stroke in nested case-control studies.

Conclusions: In Chinese patients with T2DM, SH is associated with increased risk of all-cause mortality and TIA, but no significant differences were found regard to the other examined complication risks, which need to be further explored in future studies.

Keywords: Complication; Mortality; Severe hypoglycemia; Type 2 diabetes mellitus.