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Reporting Severe Hypoglycemia in Type 1 Diabetes: Facts and Pitfalls

  • Therapies and New Technologies in the Treatment of Type 1 Diabetes (M Pietropaolo, Section Editor)
  • Published:
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Abstract

Purpose of Review

To describe potential factors influencing reporting of severe hypoglycemia in adult patients with type 1 diabetes and to analyze their effect on reported rates of severe hypoglycemia.

Recent Findings

Reported rates of severe hypoglycemia defined as need for third party assistance vary between 0.3–3.0 events per patient-year in unselected cohorts, corresponding to a yearly prevalence range of 10–53%. When defined as need for parenteral therapy with glucose or glucagon or need for admission to an emergency unit or hospitalization, incidence and prevalence rates of severe hypoglycemia are 0.02–0.5 events per patient-year and 1–29%, respectively. When subjects with recurrent severe hypoglycemia in the past or suffering from impaired hypoglycemia awareness are excluded from participation in studies, lower rates are reported. Studies applying anonymous reporting or reporting by partners report higher rates of severe hypoglycemia.

Summary

There is a large variation between studies reporting incidence and prevalence of severe hypoglycemia in patients with type 1 diabetes, mainly explained by definition of severity, methods of reporting, and patient selection. These findings call for consensus about hypoglycemia definition and reporting in future research.

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Papers of particular interest, published recently, have been highlighted as: • Of importance, •• Of major importance

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Authors and Affiliations

  1. Department of Cardiology, Nephrology and Endocrinology, Nordsjællands Hospital, Dyrehavevej 29, 3400, Hillerød, Denmark

    Ulrik Pedersen-Bjergaard & Birger Thorsteinsson

  2. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Ulrik Pedersen-Bjergaard & Birger Thorsteinsson

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Ulrik Pedersen-Bjergaard has served on advisory boards for AstraZeneca/Bristol-Myers Squibb, Novo Nordisk, and Sanofi-Aventis, and has received lecture fees from AstraZeneca/Bristol-Myers Squibb, Medtronic, Novo Nordisk, and Sanofi-Aventis.

Birger Thorsteinsson served on advisory boards for Novo Nordisk and Eli Lilly.

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This article is part of the Topical Collection on Therapies and New Technologies in the Treatment of Type 1 Diabetes

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Pedersen-Bjergaard, U., Thorsteinsson, B. Reporting Severe Hypoglycemia in Type 1 Diabetes: Facts and Pitfalls. Curr Diab Rep 17, 131 (2017). https://doi.org/10.1007/s11892-017-0965-1

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