Risk factors associated with severe hypoglycemia in older adults with type 1 diabetes

T1D Exchange Severe Hypoglycemia in Older Adults With Type 1 Diabetes Study Group

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE Severe hypoglycemia is common in older adults with long-standing type 1 diabetes, but little is known about factors associated with its occurrence. RESEARCH DESIGN AND METHODS A case-control study was conducted at 18 diabetes centers in the T1D Exchange Clinic Network. Participantswere ≥60 years oldwith type 1 diabetes for ≥20 years. Case subjects (n = 101) had at least one severe hypoglycemic event in the prior 12months. Control subjects (n = 100), frequency-matched to case subjects by age, had no severe hypoglycemia in the prior 3 years. Data were analyzed for cognitive and functional abilities, social support, depression, hypoglycemia unawareness, various aspects of diabetes management, C-peptide level, glycated hemoglobin level, and blinded continuous glucose monitoring (CGM) metrics. RESULTS Glycated hemoglobin (mean 7.8% vs. 7.7%) and CGM-measured mean glucose (175 vs. 175 mg/dL) were similar between case and control subjects. More case than control subjects had hypoglycemia unawareness: only 11% of case subjects compared with 43% of control subjects reported always having symptoms associated with low blood glucose levels (P <0.001). Case subjects had greater glucose variability than control subjects (P = 0.008) and experienced CGM glucose levels

Original languageEnglish (US)
Pages (from-to)603-610
Number of pages8
JournalDiabetes Care
Volume39
Issue number4
DOIs
StatePublished - Apr 1 2016

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Type 1 Diabetes Mellitus
Hypoglycemia
Glucose
Glycosylated Hemoglobin A
C-Peptide
Hypoglycemic Agents
Social Support
Blood Glucose
Case-Control Studies
Research Design

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

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T1D Exchange Severe Hypoglycemia in Older Adults With Type 1 Diabetes Study Group (2016). Risk factors associated with severe hypoglycemia in older adults with type 1 diabetes. Diabetes Care, 39(4), 603-610. https://doi.org/10.2337/dc15-1426

Risk factors associated with severe hypoglycemia in older adults with type 1 diabetes. / T1D Exchange Severe Hypoglycemia in Older Adults With Type 1 Diabetes Study Group.

In: Diabetes Care, Vol. 39, No. 4, 01.04.2016, p. 603-610.

Research output: Contribution to journalArticle

T1D Exchange Severe Hypoglycemia in Older Adults With Type 1 Diabetes Study Group 2016, 'Risk factors associated with severe hypoglycemia in older adults with type 1 diabetes', Diabetes Care, vol. 39, no. 4, pp. 603-610. https://doi.org/10.2337/dc15-1426
T1D Exchange Severe Hypoglycemia in Older Adults With Type 1 Diabetes Study Group. Risk factors associated with severe hypoglycemia in older adults with type 1 diabetes. Diabetes Care. 2016 Apr 1;39(4):603-610. https://doi.org/10.2337/dc15-1426
T1D Exchange Severe Hypoglycemia in Older Adults With Type 1 Diabetes Study Group. / Risk factors associated with severe hypoglycemia in older adults with type 1 diabetes. In: Diabetes Care. 2016 ; Vol. 39, No. 4. pp. 603-610.
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abstract = "OBJECTIVE Severe hypoglycemia is common in older adults with long-standing type 1 diabetes, but little is known about factors associated with its occurrence. RESEARCH DESIGN AND METHODS A case-control study was conducted at 18 diabetes centers in the T1D Exchange Clinic Network. Participantswere ≥60 years oldwith type 1 diabetes for ≥20 years. Case subjects (n = 101) had at least one severe hypoglycemic event in the prior 12months. Control subjects (n = 100), frequency-matched to case subjects by age, had no severe hypoglycemia in the prior 3 years. Data were analyzed for cognitive and functional abilities, social support, depression, hypoglycemia unawareness, various aspects of diabetes management, C-peptide level, glycated hemoglobin level, and blinded continuous glucose monitoring (CGM) metrics. RESULTS Glycated hemoglobin (mean 7.8{\%} vs. 7.7{\%}) and CGM-measured mean glucose (175 vs. 175 mg/dL) were similar between case and control subjects. More case than control subjects had hypoglycemia unawareness: only 11{\%} of case subjects compared with 43{\%} of control subjects reported always having symptoms associated with low blood glucose levels (P <0.001). Case subjects had greater glucose variability than control subjects (P = 0.008) and experienced CGM glucose levels",
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AU - DuBose, Stephanie N.

AU - Bergenstal, Richard M.

AU - Chaytor, Naomi S.

AU - Peterson, Christina

AU - Olson, Beth A.

AU - Munshi, Medha N.

AU - Perrin, Alysa J S

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AU - Liljenquist, David R.

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AU - Bhargava, Anuj

AU - Goland, Robin S.

AU - Edelen, Rachel C.

AU - Pratley, Richard E.

AU - Peters, Anne L.

AU - Rodriguez, Henry

AU - Ahmann, Andrew

AU - Lock, John Paul

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N2 - OBJECTIVE Severe hypoglycemia is common in older adults with long-standing type 1 diabetes, but little is known about factors associated with its occurrence. RESEARCH DESIGN AND METHODS A case-control study was conducted at 18 diabetes centers in the T1D Exchange Clinic Network. Participantswere ≥60 years oldwith type 1 diabetes for ≥20 years. Case subjects (n = 101) had at least one severe hypoglycemic event in the prior 12months. Control subjects (n = 100), frequency-matched to case subjects by age, had no severe hypoglycemia in the prior 3 years. Data were analyzed for cognitive and functional abilities, social support, depression, hypoglycemia unawareness, various aspects of diabetes management, C-peptide level, glycated hemoglobin level, and blinded continuous glucose monitoring (CGM) metrics. RESULTS Glycated hemoglobin (mean 7.8% vs. 7.7%) and CGM-measured mean glucose (175 vs. 175 mg/dL) were similar between case and control subjects. More case than control subjects had hypoglycemia unawareness: only 11% of case subjects compared with 43% of control subjects reported always having symptoms associated with low blood glucose levels (P <0.001). Case subjects had greater glucose variability than control subjects (P = 0.008) and experienced CGM glucose levels

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