Intensive Treatment Increases Risk of Hypoglycemia Among Diabetes Patients

Although intensive glucose-lowering treatment is common among patients with type 2 diabetes, it may increase the risk of hypoglycemia, according to new research.

The researchers conducted their study to investigate the prevalence of intensive treatment and the link between intensive treatment, clinical complexity, and risk of severe hypoglycemia among adults with type 2 diabetes who do not use insulin.

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From January 1, 2001, through December 31, 2013, the researchers collected data from a health insurance claims database for 31,542 adults with type 2 diabetes and well-controlled glucose levels—defined as achieving and maintaining HbA1c levels of less than 7%—and who were not taking insulin.

Participants were categorized as having high vs low clinical complexity if they were aged 75 years or older, had dementia or end-stage renal disease, or had 3 or more serious chronic conditions.

Data analysis showed that 3910 participants had clinical complexity. About 21% of patients with high clinical complexity and 26% of patients with low clinical complexity received intensive treatment.

Participants with high clinical complexity were 3 times more likely to develop severe hypoglycemia 2 years after receiving intensive treatment than those with low clinical complexity.

“More than 20% of patients with type 2 diabetes received intensive treatment that may be unnecessary,” the researchers concluded. “Among patients with high clinical complexity, intensive treatment nearly doubles the risk of severe hypoglycemia.”

—Amanda Balbi

Reference:

McCoy RG, Lipska KJ, Yao X, Ross JS, Montori VM, Shah ND. Intensive treatment and severe hypoglycemia among adults with type 2 diabetes [published online June 6, 2016]. JAMA Intern Med. doi:10.1001/jamainternmed.2016.2275.