Incidence of severe hypoglycemia and its association with serum adiponectin in Japanese patients with type 1 and insulin‐treated type 2 diabetes: The Fukuoka Diabetes Registry

• Published in: Journal of diabetes investigation Vol. 11; no. 5; pp. 1258 - 1264
• Main Authors: Iwase, Masanori, Komorita, Yuji, Fujii, Hiroki, Ohkuma, Toshiaki, Ide, Hitoshi, Yoshinari, Masahito, Oku, Yutaro, Higashi, Taiki, Nakamura, Udai, Kitazono, Takanari
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.09.2020; John Wiley and Sons Inc; Wiley
• Subjects: Adiponectin; Adiponectin - blood; Age; Aged; Alcohol; Biomarkers - blood; Blood Glucose - analysis; Body mass index; Clinical trials; Diabetes; Diabetes mellitus (insulin dependent); Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - pathology; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - pathology; Drug dosages; Female; Follow-Up Studies; Humans; Hypoglycemia; Hypoglycemia - blood; Hypoglycemia - chemically induced; Hypoglycemia - epidemiology; Hypoglycemia - pathology; Hypoglycemic Agents - adverse effects; Incidence; Insulin; Insulin resistance; Japan - epidemiology; Leisure; Male; Middle Aged; Original; Prognosis; Prospective Studies; Questionnaires; Registries - statistics & numerical data; Risk Factors; Sex ratio; Japan; Hypoglycemia; Insulin; Adiponectin
• ISSN: 2040-1116; 2040-1124
• DOI: 10.1111/jdi.13253

Aims/Introduction The incidence of severe hypoglycemia and its risk factors including an insulin‐sensitizing adipokine, adiponectin, were prospectively investigated in Japanese patients with type 1 or insulin‐treated type 2 diabetes. Materials and Methods A total of 207 participants with type 1 diabetes (mean age 55 years) and 1,396 with insulin‐treated type 2 diabetes (mean age 65 years) from the local diabetes registry were followed for 5 years (follow‐up rate 99%). Severe hypoglycemia was defined as events requiring the assistance of others for recovery from hypoglycemia. Results The incidence of severe hypoglycemia was 9.2 per 100 person‐years in those with type 1 diabetes, and 2.3 per 100 person‐years in those with insulin‐treated type 2 diabetes, respectively. For type 1 diabetes, the risk was significant in those with a history of severe hypoglycemia within the previous year, slow eating and higher serum adiponectin (the highest vs the lowest in quartile hazard ratio 2.36, 95% confidence interval 1.22–4.69). For insulin‐treated type 2 diabetes, the risk included age ≥65 years, history of severe hypoglycemia within the previous year, alcohol consumption ≥60 g/day, larger insulin dose and higher serum adiponectin (the highest vs the lowest in quartile, hazard ratio 2.95, 95% confidence interval 1.22–4.69). For all participants, the incidence of severe hypoglycemia increased along with serum adiponectin (age‐ and sex‐adjusted hazard ratio 1.65 per 1 standard deviation increase of log serum adiponectin, 95% confidence interval 1.45–1.87). Conclusions The incidence of severe hypoglycemia was prospectively determined, and the association between severe hypoglycemia and higher serum adiponectin was observed in Japanese patients with type 1 and insulin‐treated type 2 diabetes. The incidence of severe hypoglycemia was prospectively determined in Japanese patients with type 1 and insulin‐treated type 2 diabetes. The development of severe hypoglycemia was associated with higher serum adiponectin level.