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Open AccessArticle

Severe Hypoglycemia as a Predictor of End-Stage Renal Disease in Type 2 Diabetes: A National Cohort Study

by Yu-Li Lee 1,2,†, Shih-Jung Yen 1,2,†, Shyi-Jang Shin 2,3, Yi-Chi Huang 4, Jiun Shiuan He 1,5 and Kun-Der Lin 1,2,3,*
1
Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80145, Taiwan
2
Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
3
College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
4
Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
5
Department of Public Health, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
*
Author to whom correspondence should be addressed.
The authors contributed equally to this work.
Int. J. Environ. Res. Public Health 2019, 16(5), 681; https://doi.org/10.3390/ijerph16050681
Received: 5 January 2019 / Revised: 21 February 2019 / Accepted: 22 February 2019 / Published: 26 February 2019
Aims: This study investigated whether there is a link between severe hypoglycemia and progression into end-stage renal disease (ESRD) in patients with type 2 diabetes. Methods: Tapping into Taiwan’s Health Insurance Research Database, we identified all type 2 diabetes patients between 1996 and 2013 and identified those diagnosed with a severe hypoglycemia episode during an emergency department visit and those who were not. Controls were then matched 1:1 for age, sex, index year, and medication. Results: We identified 468,421 type 2 diabetes patients diagnosed as having severe hypoglycemia in an emergency department visit. Compared with controls, these patients with SH had a higher risk of all-cause mortality (Hazard Ratio (HR), 1.76; 95% confidence interval, 1.61–1.94) and progressed into ESRD within a shorter period of time. Results were similar after controlling for competing risk. Conclusion: Severe hypoglycemia is significantly associated with worsening renal dysfunction in patients with type 2 diabetes and hastened progression into ESRD. View Full-Text
Keywords: non-insulin dependent diabetes mellitus; ESRD; hypoglycemia non-insulin dependent diabetes mellitus; ESRD; hypoglycemia
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Lee, Y.-L.; Yen, S.-J.; Shin, S.-J.; Huang, Y.-C.; He, J.S.; Lin, K.-D. Severe Hypoglycemia as a Predictor of End-Stage Renal Disease in Type 2 Diabetes: A National Cohort Study. Int. J. Environ. Res. Public Health 2019, 16, 681.

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