Reducing Rates of Severe Hypoglycemia in a Population-Based Cohort of Children and Adolescents With Type 1 Diabetes Over the Decade 2000–2009

  1. Timothy W. Jones, MD, DCH, FRACP1,2
  1. 1Department of Endocrinology and Diabetes, Princess Margaret Hospital for Sick Children, Perth, Western Australia, Australia
  2. 2Diabetes and Endocrinology Division, Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
  3. 3Department of Biostatistics, Institute of Health and Rehabilitation Research, University of Notre Dame, Fremantle, Western Australia, Australia
  1. Corresponding author: Timothy W. Jones, timothy.jones{at}health.wa.gov.au.

Abstract

OBJECTIVE To examine rates of severe hypoglycemia (SH) in a large population-based cohort of children with type 1 diabetes and relationships to HbA1c.

RESEARCH DESIGN AND METHODS Data from 1,683 children (mean [SD] age at diagnosis 10.5 ± 4.2; range 1–18 years) from 2000 to 2009 were analyzed from the Western Australian Childhood Diabetes Database. Rates of SH were related to HbA1c using negative binomial regression.

RESULTS A total of 7,378 patient-years of data and 780 SH events were recorded. The rate of SH per 100 patient-years peaked at 17.3 in 2001 and then declined from 2004 to a nadir of 5.8 in 2006. HbA1c <7% was not associated with higher risk of SH (incidence rate ratio 1.2 [95% CI 0.9–1.6], P = 0.29) compared with HbA1c of 8–9%.

CONCLUSIONS In a sample of youth with type 1 diabetes, there has been a decrease in rates of SH and a weaker relationship with glycemic control than previously observed.

  • Received April 19, 2011.
  • Accepted August 17, 2011.

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This Article

  1. Diabetes Care
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