Severe hypoglycaemia predictive model for with type 2 diabetes created
A predictive model of long-term risk for severe hypoglycaemia in people with type 2 diabetes has been constructed.
Researchers from the University of Minnesota say the three strongest predictors for severe hypoglycaemia over five years are intensive glycemic management (HR=2.37, 95% CI 1.99 to 2.83), insulin use (HR=2.14, 95% CI 1.77 to 2.59) and antihypertensive medication use (HR=1.90, 95% CI 1.26 to 2.86).
The model was created using data from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, a randomised, multicenter, double 2×2 factorial design study examining the effect of glycemic, blood pressure, and lipid control on cardiovascular outcomes in type 2 diabetes.
Writing in the BMJ Open Diabetes Research & Care, the researchers said: “We identified 17 predictors – glycemic management, age, race, education, waist circumference, medications (insulin, antihypertensive, HMG-CoA reductase inhibitors, sulfonylurea, biguanide and meglitinide), years since diabetes diagnosis, history of hypoglycemia in the last week, systolic blood pressure, diastolic blood pressure, serum creatinine, and urinary albumin creatinine ratio—to construct a prediction model for SH (c-statistic=0.782).
“Using this information, we derived point scores to estimate the five-year risk for SH [severe hypoglycaemia] in individual patients with T2DM [type 2 diabetes]. After adjusting for other variables in the model, the three strongest predictors for SH over 5 years were intensive glycemic management (HR=2.37, 95% CI 1.99 to 2.83), insulin use (HR=2.14, 95% CI 1.77 to 2.59), and antihypertensive medication use (HR=1.90, 95% CI 1.26 to 2.86).”
They concluded: “Using the ACCORD data, we identified attributes to predict 5-year risk of SH in patients with T2DM, which warrant evaluation in broader populations to determine applicability.”
To view the open access study behind the model, click here.