It is well-known that higher rates of non-severe hypoglycemic episodes (NSHEs) associate with a greater risk of severe hypoglycemic episodes (SHEs) in patients with type 1 diabetes. We investigated whether a similar association existed in patients with type 2 diabetes (T2D). We explored if annual rate of NSHEs was associated with time to first SHE, cardiovascular (CV) death, time to first major adverse CV event (MACE), and all cause death in patients with T2D using data from LEADER, a CV outcomes trial with 9340 patients with T2D.We used a Cox proportional hazards model adjusted for randomized treatment arm, and annual rate of NSHE as a time-dependent covariate with three levels; A: <2 NSHEs per year (reference), B: 2−11 NSHEs, or C: ≥12 NSHEs. Hazard ratios were used to estimate the association between NSHE and each of the outcomes. Higher rates of NSHE were associated with a higher rate of severe hypoglycemia, MACE, CV death, and all-cause death in patients with T2D (Figure); our results suggest that in this T2D population, a high rate of NSHEs may be associated with more harmful outcomes.
S.R. Heller: Advisory Panel; Self; Eli Lilly and Company, Novo Nordisk A/S, Sanofi-Aventis, Takeda Pharmaceutical Company Limited, Zealand Pharma A/S. Consultant; Self; Novo Nordisk A/S. Speaker’s Bureau; Self; Eli Lilly and Company, Novo Nordisk A/S. E. Hachmann-Nielsen: Employee; Self; Novo Nordisk A/S. K. Kvist: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S.
Novo Nordisk
