Background: Hypoglycemia is one of the major complications in the management of individuals with type 1 diabetes, and severe hypoglycemia increases the risk of mortality.
Objective: To investigate trends and risk factors for severe hypoglycemia and mortality in individuals with type 1 diabetes.
Methods: We evaluated age- and sex-standardized annual incidence rates of severe hypoglycemia requiring hospitalization and mortality in individuals with type 1 diabetes using the Korean National Health Insurance Service Database from 2002 to 2016.
Results: Age- and sex-standardized incidence rates of severe hypoglycemia have increased from 2002 to 2016 in individuals with type 1 diabetes (5.79 per 1,000 in 2002-2004 to 12.57 per 1,000 in 2015-2016, P for trend < 0.0001). Individuals with severe hypoglycemia had significantly lower body weight (64.8 ± 12.4 kg vs. 57.7 ± 9.5 kg; P < 0.0001) and higher proportions of chronic kidney disease (2.5% vs. 5.3%, P = 0.0012) and end-stage renal disease (0.6% vs. 2.0%, P = 0.0071) compared with those without severe hypoglycemia. However, age- and sex-standardized mortality has decreased in both individuals with and without severe hypoglycemia (P for trends < 0.001). The use of new-generation insulin analogs was associated with a lower risk of severe hypoglycemia and mortality.
Conclusion: The incidence rates of severe hypoglycemia have significantly increased, while the mortality has significantly decreased in Korean individuals with type 1 diabetes from 2002 to 2016.
J. Bae: None. K. Kim: None. J. Kim: None. S. Kim: None. N. Kim: None.