Hypoglycemia in Type 2 Diabetes
Table 2—
Epidemiological data on hypoglycemia in type 2 diabetes, expressed as prevalence
| Study | Jennings, Wilson, and Ward, 1989 (ref. 75) | U.K. Prospective Diabetes Study 33, 1998 (ref. 2) | Hepburn, 1993 (ref. 83)* | VA CSDM, 1995(ref. 74) | Miller et al., 2001(ref. 76) | Henderson et al., 2003 (ref. 82)* | Leese et al., 2003 (ref. 79) | Donnelly et al., 2005 (ref. 81)* |
|---|---|---|---|---|---|---|---|---|
| Design | Retrospective, structured interview | Prospective multicentre randomized clinical trial | Retrospective, questionnaire | Prospective multicenter randomized clinical trial | Retrospective, interview | Retrospective questionnaire | Population-based dataset analysis | Prospective |
| Subjects | Type 2 diabetes, oral antidiabetic agents only | Type 2 diabetes, oral antidiabetic agents and insulin | Types 1 and 2 diabetes, insulin only | All type 2 diabetes | Type 2 diabetes | Insulin-treated type 2 diabetes | Mixed type 1 and type 2 diabetic subjects, oral antidiabetic agents and insulin | Insulin-treated type 1 and type 2 diabetic subjects |
| Number | 219 (sulfonylurea 203, metformin 16) | 3,935 | 104 type 1 and 104 type 2 diabetic subjects | 153 | 1,055 | 215 | 160 | 94 type 1 and 173 type 2 diabetic subjects |
| Age | 59 (40–65) | 54 ± 8 | 63 ± 9 | 60 ± 6 | 60.9 ± 0.4 (means ± SE) | 68 (27–87) | 53.8 (50.8–56.9) | 66 (34–86) |
| A1C % | — | 6.2 ± 1.2 | — | 9.3 ± 1.8 | 7.6 ± 0.1 (means ± SE) | 8.6 ± 1.5 | 7.85 (7.57–8.14) | 8.9 ± 1.41 |
| HbA1% | Subjects with hypoglycemia 9.5 ± 9, subjects without hypoglycemia 11.4 ± 3.0 | — | 10.3 ± 2 | — | — | — | — | — |
| Duration | 6 months | 10 years | 1 year | 18–35 months | 7 months | 1 year | 1 year | 1 month |
| Definition of severe hypoglycemia | NA | Third party assistance | Third party assistance | Third party assistance/LOC/fit | Third party assistance | Third party assistance | Need for parenteral treatment by emergency services | Third party assistance |
| Oral antidiabetic agents: all hypoglycemia | Metformin 0%, sulfonylurea 20.2% (glyburide 31.3%, chlorpropamide 13.6%, gliclazide 13.1%) | Glyburide 17.0%, chlorpropamide 11.0% | NA | NA | 16% | NA | NA | NA |
| Oral antidiabetic agents: severe hypoglycemia | — | Glyburide 0.6%, chlorpropamide 0.4% | NA | NA | 0% | NA | 0.8% | NA |
| Insulin: all hypoglycemia | NA | 36.5% | 82.7% | 56% (conventional), 93% (intensive) | 30% | 64% | NA | 45% |
| Insulin: severe hypoglycemia | NA | 2.3% | 10% | NA | 0% | 15% | 7.3% | 3% |
| Main criticisms | Recall bias for mild hypoglycemia | Atypical intensively managed group. Under-recording of events | — | All male, intensively managed | Recall bias. Mainly female African Americans | Recall bias for mild hypoglycemia | Only assessed hypoglycemia requiring emergency services | Short duration |
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Data are means ± SD or median (range), unless otherwise indicated. LOC, loss of consciousness; NA, not applicable; VA CSDM, Veterans Affairs Cooperative Study in Type 2 Diabetes.
- *
↵* Only figures for type 2 diabetes given.
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Diabetes Care December 2005 vol. 28 no. 12 2948-2961
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