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Risk factors associated with mortality in individuals with type 2 diabetes following an episode of severe hypoglycaemia. Results from a randomised controlled trial

BACKGROUND: Severe hypoglycaemia may pose significant risk to individuals with type 2 diabetes (T2D), and evidence surrounding strategies to mitigate this risk is lacking. METHODS: Data was re-analysed from a previous randomised controlled trial studying the impact of nurse-led intervention on morta...

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Autores principales: Pearson, Sam M, Kietsiriroje, Noppadol, Whittam, Beverley, Birch, Rebecca J, Campbell, Matthew D, Ajjan, Ramzi A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8801660/
https://www.ncbi.nlm.nih.gov/pubmed/35089082
http://dx.doi.org/10.1177/14791641211067415
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author Pearson, Sam M
Kietsiriroje, Noppadol
Whittam, Beverley
Birch, Rebecca J
Campbell, Matthew D
Ajjan, Ramzi A
author_facet Pearson, Sam M
Kietsiriroje, Noppadol
Whittam, Beverley
Birch, Rebecca J
Campbell, Matthew D
Ajjan, Ramzi A
author_sort Pearson, Sam M
collection PubMed
description BACKGROUND: Severe hypoglycaemia may pose significant risk to individuals with type 2 diabetes (T2D), and evidence surrounding strategies to mitigate this risk is lacking. METHODS: Data was re-analysed from a previous randomised controlled trial studying the impact of nurse-led intervention on mortality following severe hypoglycaemia in the community. A Cox-regression model was used to identify baseline characteristics associated with mortality and to adjust for differences between groups. Kaplan-Meier curves were created to demonstrate differences in outcome between groups across different variables. RESULTS: A total of 124 participants (mean age = 75, 56.5% male) were analysed. In univariate analysis, Diabetes Severity Score (DSS), age and insulin use were baseline factors found to correlate to mortality, while HbA1C and established cardiovascular disease showed no significant correlations. Hazard ratio favoured the intervention (0.68, 95% CI: 0.38–1.19) and in multivariate analysis, only DSS demonstrated a relationship with mortality. Comparison of Kaplan-Meier curves across study groups suggested the intervention is beneficial irrespective of HbA1c, diabetes severity score or age. CONCLUSION: While DSS predicts mortality following severe community hypoglycaemia in individuals with T2D, a structured nurse-led intervention appears to reduce the risk of death across a range of baseline parameters.
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spelling pubmed-88016602022-02-01 Risk factors associated with mortality in individuals with type 2 diabetes following an episode of severe hypoglycaemia. Results from a randomised controlled trial Pearson, Sam M Kietsiriroje, Noppadol Whittam, Beverley Birch, Rebecca J Campbell, Matthew D Ajjan, Ramzi A Diab Vasc Dis Res Brief Report BACKGROUND: Severe hypoglycaemia may pose significant risk to individuals with type 2 diabetes (T2D), and evidence surrounding strategies to mitigate this risk is lacking. METHODS: Data was re-analysed from a previous randomised controlled trial studying the impact of nurse-led intervention on mortality following severe hypoglycaemia in the community. A Cox-regression model was used to identify baseline characteristics associated with mortality and to adjust for differences between groups. Kaplan-Meier curves were created to demonstrate differences in outcome between groups across different variables. RESULTS: A total of 124 participants (mean age = 75, 56.5% male) were analysed. In univariate analysis, Diabetes Severity Score (DSS), age and insulin use were baseline factors found to correlate to mortality, while HbA1C and established cardiovascular disease showed no significant correlations. Hazard ratio favoured the intervention (0.68, 95% CI: 0.38–1.19) and in multivariate analysis, only DSS demonstrated a relationship with mortality. Comparison of Kaplan-Meier curves across study groups suggested the intervention is beneficial irrespective of HbA1c, diabetes severity score or age. CONCLUSION: While DSS predicts mortality following severe community hypoglycaemia in individuals with T2D, a structured nurse-led intervention appears to reduce the risk of death across a range of baseline parameters. SAGE Publications 2022-01-28 /pmc/articles/PMC8801660/ /pubmed/35089082 http://dx.doi.org/10.1177/14791641211067415 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Brief Report
Pearson, Sam M
Kietsiriroje, Noppadol
Whittam, Beverley
Birch, Rebecca J
Campbell, Matthew D
Ajjan, Ramzi A
Risk factors associated with mortality in individuals with type 2 diabetes following an episode of severe hypoglycaemia. Results from a randomised controlled trial
title Risk factors associated with mortality in individuals with type 2 diabetes following an episode of severe hypoglycaemia. Results from a randomised controlled trial
title_full Risk factors associated with mortality in individuals with type 2 diabetes following an episode of severe hypoglycaemia. Results from a randomised controlled trial
title_fullStr Risk factors associated with mortality in individuals with type 2 diabetes following an episode of severe hypoglycaemia. Results from a randomised controlled trial
title_full_unstemmed Risk factors associated with mortality in individuals with type 2 diabetes following an episode of severe hypoglycaemia. Results from a randomised controlled trial
title_short Risk factors associated with mortality in individuals with type 2 diabetes following an episode of severe hypoglycaemia. Results from a randomised controlled trial
title_sort risk factors associated with mortality in individuals with type 2 diabetes following an episode of severe hypoglycaemia. results from a randomised controlled trial
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8801660/
https://www.ncbi.nlm.nih.gov/pubmed/35089082
http://dx.doi.org/10.1177/14791641211067415
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