Severe hypoglycaemia prediction model developed for type 2 diabetes
A risk prediction model for severe hypoglycaemia in adults with type 2 diabetes has been developed and validated in a study.
Researchers from The Catholic University of Korea and Institute of Environmental Health Sciences in America created the tool as part of a nationwide population-based cohort study, with the findings published in the open-access journal Clinical Epidemiology.
Using the National Health Insurance Database (DB) in Korea, the research team tracked baseline and follow-up data of people with type 2 diabetes who received health evaluations between January 1, 2009, and December 31, 2010. The participants (n=1,676,885) were analyzed as development (n=1,173,820) and validation (n=503,065) cohorts.
New episodes of severe hypoglycaemia were identified using ICD-10 codes. A Cox proportional hazards regression model and Cox model coefficients were used to create a risk scoring system, and 14 predictive variables were selected. A risk score nomogram based on the risk prediction model was created to estimate the one-year risk of severe hypoglycaemia.
Summarising the results, the researchers said: “In the development cohort, a total of 5,325 (0.45%) patients experienced SH episodes during the follow-up period. After multivariable adjustment, older age, female sex, current smoker, drinking, low body mass index, lack of exercise, previous SH events, insulin or multiple oral hypoglycaemic agent use, presence of hypertension or chronic kidney disease, longer duration of diabetes, low or high glucose level, and high Charlson Comorbidity Index score were found to be significant risk factors for the development of SH and were incorporated into the risk model.
“The concordance indices were 0.871 (95% confidence interval, 0.863–0.881) in development cohort and 0.866 (95% CI, 0.856–0.879) in the validation cohort. The calibration plot showed a nearly 45° line, which indicates that this model predicts well an absolute SH event.”
Concluding, they said: “This 14-variable prediction model for SH [severe hypoglycaemia] events may be a useful tool to identify high-risk patients and guide prevention of SH in adult patients with T2DM [type 2 diabetes].”
To access the study, click here.