Occurrence of severe hypoglycaemic events among US youth and young adults with type 1 or type 2 diabetes

OBJECTIVE: Although severe hypoglycaemia (SH) can lead to adverse health outcomes, little is known about its occurrence and re‐occurrence among youth with type 1 or type 2 diabetes. METHODS: This study included 2740 participants aged <20 years at diabetes diagnosis and 5‐14 years diabetes duration from the SEARCH for Diabetes in Youth Cohort Study. Participants reported SH events in the past 6 months. Differences in SH events by demographic and clinical factors were tested using logistic regression models. RESULTS: Severe hypoglycaemia in the past 6 months was more common among youth with type 1 (7.0%, 168 of 2399) than with type 2 diabetes (2.6%, nine of 341) (P < 0.002). The median number of SH events per youth who had at least one SH event in the past 6 months was 1 for both type 1 type 2 diabetes. For youth with type 1 diabetes, those who reported SH events were older, were more likely to have obesity or to be physically active, and had lower HbA1c. After adjustments, one unit increase in HbA1c was associated with 16% lower likelihood (OR 0.84, 95% CI 0.75, 0.94) and being physically active was associated with an 87% higher likelihood (OR 1.87, 95% CI 1.23, 2.86) of reporting a SH event. There were too few SH events among youth with type 2 diabetes to analyse further. CONCLUSIONS: In youth with diabetes, SH was common even within a short 6‐month window. Better understanding the causes of SH may help prevent them from occurring.