Tags

Type your tag names separated by a space and hit enter

Secondary diabetic ketoacidosis and severe hypoglycaemia in patients with established type 1 diabetes mellitus in China: a multicentre registration study.
Diabetes Metab Res Rev. 2014 Sep; 30(6):497-504.DM

Abstract

BACKGROUND

Diabetic ketoacidosis (DKA) and severe hypoglycaemia are common acute complications of type 1 diabetes mellitus (T1DM). This study aimed to determine the incidence of, and risk factors for, these complications in Chinese patients with established T1DM.

METHODS

This cross-sectional study recruited patients with established T1DM from 16 centres in Guangdong Province, China. Incidence rates were expressed as episodes/100 patient-years. Regression models identified risk factors for the occurrence and recurrence of secondary DKA and severe hypoglycaemia.

RESULTS

A total of 611 patients with established T1DM (53.7% women) were recruited. The incidence of secondary DKA and severe hypoglycaemia was 26.4 (22.4, 31.0) and 68.8 (62.2, 76.0)/100 patient-years, respectively. Significant risk factors for secondary DKA were female gender [relative risk (RR) = 2.12], medical reimbursement rate <50% (RR = 1.84), uncontrolled diet (RR = 1.76), smoking (RR = 2.18) and poor glycaemic control [glycated haemoglobin A1c (HbA1c)/1.0% increase; RR = 1.15]. Overweight/obesity was a protective factor (RR = 0.57). Significant risk factors for severe hypoglycaemia included male gender (RR = 1.71), medical reimbursement rate < 50% (RR = 1.36), longer duration of T1DM (per 5-year increase, RR = 1.22), underweight (RR = 1.44), uncontrolled diet ('never controlled' or 'sometimes controlled' vs. 'usually controlled', RR = 2.09 or 2.02, respectively), exercise <150 min/week (RR = 1.66), presence of neuropathy (RR = 1.89), smoking (RR = 1.48) and lower HbA1c values (per 1.0% decrease, RR = 1.46). Overweight/obesity was a protective factor (RR = 0.62). Additionally, 34.4% of secondary DKA and 81.1% of severe hypoglycaemia episodes occurred in 3.8% and 16.2% patients with recurrent events (≥two episodes), respectively.

CONCLUSIONS

The results indicate that secondary DKA and severe hypoglycaemia occur at high rates in Chinese patients with established T1DM and that recurrence is likely to occur in high-risk patients. Comprehensive management of T1DM should include recommendations to control modifiable risk factors.

Authors+Show Affiliations

Department of Endocrinology and Metabolic Disease of the Third Affiliated Hospital, and Guangdong Provincial Key Laboratory of Diabetology, Sun Yat-Sen University, Guangzhou, China; Guangdong Diabetes Center, Sun Yat-sen University, Guangzhou, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24687395

Citation

Li, Jin, et al. "Secondary Diabetic Ketoacidosis and Severe Hypoglycaemia in Patients With Established Type 1 Diabetes Mellitus in China: a Multicentre Registration Study." Diabetes/metabolism Research and Reviews, vol. 30, no. 6, 2014, pp. 497-504.
Li J, Yang D, Yan J, et al. Secondary diabetic ketoacidosis and severe hypoglycaemia in patients with established type 1 diabetes mellitus in China: a multicentre registration study. Diabetes Metab Res Rev. 2014;30(6):497-504.
Li, J., Yang, D., Yan, J., Huang, B., Zhang, Y., & Weng, J. (2014). Secondary diabetic ketoacidosis and severe hypoglycaemia in patients with established type 1 diabetes mellitus in China: a multicentre registration study. Diabetes/metabolism Research and Reviews, 30(6), 497-504. https://doi.org/10.1002/dmrr.2547
Li J, et al. Secondary Diabetic Ketoacidosis and Severe Hypoglycaemia in Patients With Established Type 1 Diabetes Mellitus in China: a Multicentre Registration Study. Diabetes Metab Res Rev. 2014;30(6):497-504. PubMed PMID: 24687395.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Secondary diabetic ketoacidosis and severe hypoglycaemia in patients with established type 1 diabetes mellitus in China: a multicentre registration study. AU - Li,Jin, AU - Yang,Daizhi, AU - Yan,Jinhua, AU - Huang,Bin, AU - Zhang,Yan, AU - Weng,Jianping, AU - ,, PY - 2013/09/24/received PY - 2014/03/05/revised PY - 2014/03/17/accepted PY - 2014/4/2/entrez PY - 2014/4/2/pubmed PY - 2015/5/16/medline KW - Chinese KW - diabetes mellitus KW - diabetic ketoacidosis KW - incidence KW - risk factors KW - severe hypoglycaemia KW - type 1 SP - 497 EP - 504 JF - Diabetes/metabolism research and reviews JO - Diabetes Metab Res Rev VL - 30 IS - 6 N2 - BACKGROUND: Diabetic ketoacidosis (DKA) and severe hypoglycaemia are common acute complications of type 1 diabetes mellitus (T1DM). This study aimed to determine the incidence of, and risk factors for, these complications in Chinese patients with established T1DM. METHODS: This cross-sectional study recruited patients with established T1DM from 16 centres in Guangdong Province, China. Incidence rates were expressed as episodes/100 patient-years. Regression models identified risk factors for the occurrence and recurrence of secondary DKA and severe hypoglycaemia. RESULTS: A total of 611 patients with established T1DM (53.7% women) were recruited. The incidence of secondary DKA and severe hypoglycaemia was 26.4 (22.4, 31.0) and 68.8 (62.2, 76.0)/100 patient-years, respectively. Significant risk factors for secondary DKA were female gender [relative risk (RR) = 2.12], medical reimbursement rate <50% (RR = 1.84), uncontrolled diet (RR = 1.76), smoking (RR = 2.18) and poor glycaemic control [glycated haemoglobin A1c (HbA1c)/1.0% increase; RR = 1.15]. Overweight/obesity was a protective factor (RR = 0.57). Significant risk factors for severe hypoglycaemia included male gender (RR = 1.71), medical reimbursement rate < 50% (RR = 1.36), longer duration of T1DM (per 5-year increase, RR = 1.22), underweight (RR = 1.44), uncontrolled diet ('never controlled' or 'sometimes controlled' vs. 'usually controlled', RR = 2.09 or 2.02, respectively), exercise <150 min/week (RR = 1.66), presence of neuropathy (RR = 1.89), smoking (RR = 1.48) and lower HbA1c values (per 1.0% decrease, RR = 1.46). Overweight/obesity was a protective factor (RR = 0.62). Additionally, 34.4% of secondary DKA and 81.1% of severe hypoglycaemia episodes occurred in 3.8% and 16.2% patients with recurrent events (≥two episodes), respectively. CONCLUSIONS: The results indicate that secondary DKA and severe hypoglycaemia occur at high rates in Chinese patients with established T1DM and that recurrence is likely to occur in high-risk patients. Comprehensive management of T1DM should include recommendations to control modifiable risk factors. SN - 1520-7560 UR - https://www.unboundmedicine.com/medline/citation/24687395/Secondary_diabetic_ketoacidosis_and_severe_hypoglycaemia_in_patients_with_established_type_1_diabetes_mellitus_in_China:_a_multicentre_registration_study_ L2 - https://doi.org/10.1002/dmrr.2547 DB - PRIME DP - Unbound Medicine ER -