Severe hypoglycemia rates are not associated with HbA1c: a cross-sectional analysis of 3 contemporary pediatric diabetes registry databases: HAYNES et al.
Open accessAbstract
OBJECTIVE: To examine the association between glycated hemoglobin (HbA1c) and severe hypoglycemia rates in patients with type 1 diabetes receiving usual care, by analysing data from the US Type 1 Diabetes Exchange (T1DX), German/Austrian Diabetes Patienten Verlaufsdokumenation (DPV), and Western Australian Children Diabetes Database (WACDD) diabetes registries. METHODS: Data for patients with type 1 diabetes, aged <18 years with a minimum duration of diabetes of 2 years, were extracted from each registry for a 12-month observation period between 2011 and 2012 (7,102 T1DX, 18,887 DPV, and 865 WACDD). Rates of severe hypoglycemia (self-reported loss of consciousness/convulsion) were estimated per 100 patient-years and analyzed by HbA1c, source registry, treatment regimen, and age group. RESULTS: Overall, the severe hypoglycemia rate per 100 patient years was 7.1, 3.3, and 6.7 in T1DX, DPV, and WACDD patients, respectively. Lower HbA1c was not associated with an increased rate of severe hypoglycemia when examined by source registry, treatment regimen, or age group. CONCLUSION: An inverse relationship between mean HbA1c and risk of severe hypoglycemia was not observed in this study of 3, independent cohorts of children and adolescents with type 1 diabetes. Investigation in other large, longitudinal cohorts is recommended to further characterize the contemporary relationship between glycemic control and risk of severe hypoglycemia rates in pediatric patients with type 1 diabetes.
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Observational evidence indicates that worse diabetes control does not lower the chance of severe hypoglycaemia.
“Observational studies suggest poor diabetes control does not reduce the risk of severe hypoglycaemia.113”
From Type 1 diabetes (2018) · cites this paper as [113]
The Results report no inverse relationship between HbA1c and severe hypoglycemia rates across three registry cohorts, supporting the claim's direction. The Discussion specifies that these were youth with type 1 diabetes; the citing sentence leaves that population restriction unstated and could be read as applying to diabetes generally. (LLM, conf=0.83)
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- Authors
- Haynes, A., Hermann, J. M., Miller, K. M., Hofer, S. E., Jones, T. W., Beck, R. W., Maahs, D. M., Davis, E. A., Holl, R. W., & for the T1D Exchange, W. A. D. R.
- Affiliations
- The Kids Research Institute Australia (AU)
- Universität Ulm (DE)
- Jaeb Center for Health Research (US)
- Innsbruck Medical University (AT)
- Stanford Medicine (US)
- Corresponding author
- Haynes, Aveni
- ORCID
- Venue
- Pediatric Diabetes
- Publisher
- Wiley
- Published
- 2016-11-23
- Volume
- 18
- Issue
- 7
- Pages
- 643-650
- ISSN
- 1399-543X (ISSN-L)
- PMC
- PMC7162500
- OpenAlex
- W2551570543
- Cited by
- 88
- References
- 29
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 5 · 2023: 6 · 2022: 12 · 2021: 8 · 2020: 13 · 2019: 12 · 2018: 16 · 2017: 8
- FWCI
- 12.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Pediatric Diabetes (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
- Funders
- The Type 1 Diabetes Exchange Clinic Registry
- Helmsley Charitable Trust
- DPV registry
- German Center for Diabetes Research (DZD)
- German Diabetes Association (DDG)
- European Foundation for the Study of Diabetes (EFSD)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- severe hypoglycemia, HbA1c, type 1 diabetes, glycemic control, loss of consciousness, diabetes registry, usual care, children and adolescents
- MeSH terms
- Adolescent, Austria, Child, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Female, Germany, Glycated Hemoglobin, Humans, Hypoglycemia, Longitudinal Studies, Male, Prospective Studies, Registries, Risk, Seizures, Severity of Illness Index, Unconsciousness, United States, Western Australia, Cohort Studies, Incidence, Electronic Health Records
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