Severe Hypoglycemia as a Predictor of End-Stage Renal Disease in Type 2 Diabetes: A National Cohort Study

• Main Authors: Yu-Li Lee, Shih-Jung Yen, Shyi-Jang Shin, Yi-Chi Huang, Jiun Shiuan He, Kun-Der Lin
• Format: Article
• Language: English
• Published: MDPI AG 2019-02-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: non-insulin dependent diabetes mellitus; ESRD; hypoglycemia
• Online Access: https://www.mdpi.com/1660-4601/16/5/681

<b>Aims:</b> This study investigated whether there is a link between severe hypoglycemia and progression into end-stage renal disease (ESRD) in patients with type 2 diabetes. <b>Methods:</b> Tapping into Taiwan&#8217;s Health Insurance Research Database, we identified all type 2 diabetes patients between 1996 and 2013 and identified those diagnosed with a severe hypoglycemia episode during an emergency department visit and those who were not. Controls were then matched 1:1 for age, sex, index year, and medication. <b>Results:</b> We identified 468,421 type 2 diabetes patients diagnosed as having severe hypoglycemia in an emergency department visit. Compared with controls, these patients with SH had a higher risk of all-cause mortality (Hazard Ratio (HR), 1.76; 95% confidence interval, 1.61&#8315;1.94) and progressed into ESRD within a shorter period of time. Results were similar after controlling for competing risk. <b>Conclusion:</b> Severe hypoglycemia is significantly associated with worsening renal dysfunction in patients with type 2 diabetes and hastened progression into ESRD.