OBJECTIVES :

To evaluate the event rate of hypoglycemia and prevalence for diabetes comorbidities in patients with type 2 diabetes (T2D) in Tianjin, China.

METHODS :

Adult patients with T2D were selected from the Tianjin Urban Employee Basic Medical Insurance (UEBMI) Special Outpatient System for diabetes (2011-2015). Hypoglycemia events were identified by primary diagnosis of both inpatient and outpatient claims, with the first date of hypoglycemia diagnosis defined as index date. Ten controls were matched to hypoglycemia group using the eligibility of UEBMI, first T2D diagnosis date, and designated the same index date of their matched cases. The prevalence of macrovascular and microvascular diabetes complications and diabetes comorbidities were calculated in the period of 12 months post index date.

RESULTS :

Among 60,607 eligible patients with T2D (mean age ± standard deviation: 59.5.±10.6 years, 46.3% female), 1,225 (2.0%) experienced at least one episode of severe hypoglycemia, and the event rate was 1.84 episodes per 100 person-years (95% CI, 1.79-1.90). A total of 7,876 patients (716 in hypoglycemia-cohort vs. 7,160 in controlled) were included in the retrospective cohort study, and the prevalence of both macrovascular and microvascular complications were significantly higher in patients who experienced hypoglycemia than control group, including cerebrovascular disease (31.6% vs. 26.8%, P=0.007), peripheral vascular disease (57.3% vs. 38.6%, P<0.001), nephropathy (30.6% vs. 21.7%, P<0.001). Mean Charlson comorbidity index (4.38 vs, 3.80, P<0.001) and the prevalence of other comorbidities, including hypertension (79.9% vs. 75.3%, P<0.001), depression (7.0% vs. 4.5%, P=0.002), were also significant higher in patients who experienced hypoglycaemia.

CONCLUSIONS :

Over 12 months follow up, patients with T2D who experienced hypoglycemia had higher prevalence of diabetes comorbidities compared to patients who did not experience hypoglycemia.