Reducing Rates of Severe Hypoglycemia in a Population-Based Cohort of Children and Adolescents With Type 1 Diabetes Over the Decade 2000–2009
- Susan M. O'Connell, MRCPI, MD1,2,
- Matthew N. Cooper2,
- Max K. Bulsara, PHD, MSC3,
- Elizabeth A. Davis, FRACP, PHD1,2 and
- Timothy W. Jones, MD, DCH, FRACP1,2⇓
- 1Department of Endocrinology and Diabetes, Princess Margaret Hospital for Sick Children, Perth, Western Australia, Australia
- 2Diabetes and Endocrinology Division, Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
- 3Department of Biostatistics, Institute of Health and Rehabilitation Research, University of Notre Dame, Fremantle, Western Australia, Australia
- Corresponding author: Timothy W. Jones, .
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.
- © 2011 by the American Diabetes Association.
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