Incidence of severe hypoglycemia and its association with serum adiponectin in Japanese patients with type 1 and insulin‐treated type 2 diabetes: The Fukuoka Diabetes Registry

• Main Authors: Masanori Iwase, Yuji Komorita, Hiroki Fujii, Toshiaki Ohkuma, Hitoshi Ide, Masahito Yoshinari, Yutaro Oku, Taiki Higashi, Udai Nakamura, Takanari Kitazono
• Format: Article
• Language: English
• Published: Wiley 2020-09-01
• Series: Journal of Diabetes Investigation
• Subjects: Adiponectin; Hypoglycemia; Insulin
• Online Access: https://doi.org/10.1111/jdi.13253
• ISSN: 2040-1116; 2040-1124

Abstract Aims/Introduction The incidence of severe hypoglycemia and its risk factors including an insulin‐sensitizing adipokine, adiponectin, were prospectively investigated in Japanese patients with type 1 or insulin‐treated type 2 diabetes. Materials and Methods A total of 207 participants with type 1 diabetes (mean age 55 years) and 1,396 with insulin‐treated type 2 diabetes (mean age 65 years) from the local diabetes registry were followed for 5 years (follow‐up rate 99%). Severe hypoglycemia was defined as events requiring the assistance of others for recovery from hypoglycemia. Results The incidence of severe hypoglycemia was 9.2 per 100 person‐years in those with type 1 diabetes, and 2.3 per 100 person‐years in those with insulin‐treated type 2 diabetes, respectively. For type 1 diabetes, the risk was significant in those with a history of severe hypoglycemia within the previous year, slow eating and higher serum adiponectin (the highest vs the lowest in quartile hazard ratio 2.36, 95% confidence interval 1.22–4.69). For insulin‐treated type 2 diabetes, the risk included age ≥65 years, history of severe hypoglycemia within the previous year, alcohol consumption ≥60 g/day, larger insulin dose and higher serum adiponectin (the highest vs the lowest in quartile, hazard ratio 2.95, 95% confidence interval 1.22–4.69). For all participants, the incidence of severe hypoglycemia increased along with serum adiponectin (age‐ and sex‐adjusted hazard ratio 1.65 per 1 standard deviation increase of log serum adiponectin, 95% confidence interval 1.45–1.87). Conclusions The incidence of severe hypoglycemia was prospectively determined, and the association between severe hypoglycemia and higher serum adiponectin was observed in Japanese patients with type 1 and insulin‐treated type 2 diabetes.