Low ambient temperatures correlate with increased risk of hypoglycemia in patients with type 2 diabetes: An ecological study in Taiwan

Little evidence is available about the relationship between ambient temperatures and hypoglycemia in Taiwan. The purpose of the present paper is to investigate whether there is an association between ambient temperatures and hypoglycemia in patients with type 2 diabetes. An ecological study was conducted to analyze the type 2 diabetes dataset of the Taiwan National Health Insurance Program. Every episode of hypoglycemia diagnosed at emergency department among subjects with type 2 diabetes was identified monthly between 2006 and 2013. Average monthly ambient temperatures in Celsius between 2006 and 2013 were measured according to the database of the Central Weather Bureau in Taiwan. The incidence rates of hypoglycemia were higher during the period of cold ambient temperatures (from December to March) than the period of warm ambient temperatures (from April to November). The peak period of hypoglycemia always occurred in winter months (January and February). Patients with type 2 diabetes in Taiwan are more susceptible to hypoglycemia during the period of cold ambient temperatures, particularly in winter months. Clinicians in Taiwan should remind patients to make a preventive strategy for hypoglycemia during the periods of cold ambient temperatures.