Frequency and predictors of confirmed hypoglycaemia in type 1 and insulin-treated type 2 diabetes mellitus patients in a real-life setting: results from the DIALOG study
Abstract
Aim DIALOG assessed the prevalence and predictors of hypoglycaemia in patients with type 1 (T1DM) or insulin-treated type 2 diabetes mellitus (T2DM) in a real-life setting.Methods In this observational study, insulin-treated patients (n=3048) completed prospective daily questionnaires reporting the frequency and consequences of severe/confirmed non-severe hypoglycaemia over 30 days. Patients (n=3743) also retrospectively reported severe hypoglycaemia over the preceding year.Results In this prospective survey, 85.3% and 43.6% of patients with T1DM and T2DM, respectively, reported experiencing at least one confirmed hypoglycaemic event over 30 days, while 13.4% and 6.4%, respectively, reported at least one severe event. Hypoglycaemia frequency increased with longer duration of diabetes and insulin therapy. Strongly predictive factors for hypoglycaemia were previous hypoglycaemia, >2 injections/day, BMI<30kg/m(2) and duration of insulin therapy>10 years. HbA1c level was not predictive of hypoglycaemia in either T1DM or T2DM. The confirmed hypoglycaemia rate was increased in the lowest compared with the highest tertile of HbA1c in T1DM, but not T2DM. At the time of enrolment, physicians reported severe hypoglycaemia in 23.6% and 11.9% of T1DM and T2DM patients, respectively, during the preceding year; the retrospective survey yielded frequencies of 31.5% and 21.7%, respectively. Also, severe hypoglycaemia led to medical complications in 10.7% and 7.8% of events in T1DM and T2DM patients, respectively, over 30 days.Conclusion Using a unique combined prospective and retrospective approach, the DIALOG study found a relatively high frequency of hypoglycaemia among insulin-treated patients. These findings emphasize the importance of a patient-centred approach for managing diabetes in which hypoglycaemia risk evaluation is critical.Trial registration ClinicalTrials.gov: NCT01628341.
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Older and/or high-risk individuals with diabetes are at notably higher risk for severe hypoglycemia due to age, duration of diabetes, duration of insulin therapy, and greater prevalence of hypoglycemia unawareness.
“Older and/or high-risk individuals with diabetes are at notably higher risk for severe hypoglycemia due to age, duration of diabetes, duration of insulin therapy, and greater prevalence of hypoglycemia unawareness (54-58).”
From Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range (2019) · cites this paper as [55]
Older and/or high-risk individuals with diabetes are at elevated risk for hypoglycemia.
“Although there is no evidence regarding time in range for older and/or high-risk individuals, numerous studies have shown the elevated risk for hypoglycemia in these populations (54-59).”
From Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range (2019) · cites this paper as [55]
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References 27 · Cited by 129
- Authors
- Cariou, B., Fontaine, P., Eschwege, E., Lièvre, M., Gouet, D., Huet, D., Madani, S., Lavigne, S., & Charbonnel, B.
- Affiliations
- Centre Hospitalier Universitaire de Nantes (FR)
- Centre Hospitalier Universitaire de Lille (FR)
- Centre Hospitalier de La Rochelle (FR)
- Hôpital Paris Saint-Joseph (FR)
- Corresponding author
- Cariou, B.
- Venue
- Diabetes & Metabolism
- Publisher
- Elsevier BV
- Published
- 2015-04
- Volume
- 41
- Issue
- 2
- Pages
- 116-125
- ISSN
- 1262-3636 (ISSN-L)
- OpenAlex
- W1971329074
- Cited by
- 129
- References
- 27
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 6 · 2023: 11 · 2022: 6 · 2021: 14 · 2020: 15 · 2019: 6 · 2018: 14 · 2017: 26 · 2016: 13 · 2015: 10
- FWCI
- 13.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Novo Nordisk
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Keywords
- hypoglycemia, type 1 diabetes, type 2 diabetes, insulin-treated diabetes, severe hypoglycemia, HbA1c, body mass index
- MeSH terms
- Adult, Aged, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Male, Middle Aged, Prospective Studies, Retrospective Studies, Risk Factors, Prevalence
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