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

摘要

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.