Prevalence and Incidence of Hypoglycaemia in 532,542 People with Type 2 Diabetes on Oral Therapies and Insulin: A Systematic Review and Meta-Analysis of Population Based Studies

被引:151
作者
Edridge, Chloe L. [1 ]
Dunkley, Alison J. [2 ]
Bodicoat, Danielle H. [2 ]
Rose, Tanith C. [2 ]
Gray, Laura J. [3 ]
Davies, Melanie J. [2 ]
Khunti, Kamlesh [2 ]
机构
[1] Univ Leicester, Leicester Gen Hosp, Leicester Diabet Ctr, Dept Hlth Sci, Leicester, Leics, England
[2] Univ Leicester, Leicester Gen Hosp, Leicester Diabet Ctr, Diabet Res Ctr, Leicester, Leics, England
[3] Univ Leicester, Dept Hlth Sci, Leicester, Leics, England
关键词
GLYCEMIC CONTROL; WEIGHT-GAIN; METFORMIN; FREQUENCY; GLUCOSE; EVENTS; ASSOCIATION; MANAGEMENT; EXENATIDE; GLARGINE;
D O I
10.1371/journal.pone.0126427
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Objective To collate and evaluate the current literature reporting the prevalence and incidence of hypoglycaemia in population based studies of type 2 diabetes. Research Design and Methods Medline, Embase and Cochrane were searched up to February 2014 to identify population based studies reporting the proportion of people with type 2 diabetes experiencing hypoglycaemia or rate of events experienced. Two reviewers independently screened studies for eligibility and extracted data for included studies. Random effects meta-analyses were carried out to calculate the prevalence and incidence of hypoglycaemia. Results 46 studies (n = 532,542) met the inclusion criteria. Prevalence of hypoglycaemia was 45% (95% CI 0.34,0.57) for mild/moderate and 6% (95% CI, 0.05,0.07) for severe. Incidence of hypoglycaemic episodes per person-year for mild/moderate and for severe was 19 (95% CI 0.00, 51.08) and 0.80 (95% CI 0.00,2.15), respectively. Hypoglycaemia was prevalent amongst those on insulin; for mild/moderate episodes the prevalence was 50% and incidence 23 events per person-year, and for severe episodes the prevalence was 21% and incidence 1 event per person-year. For treatment regimes that included a sulphonylurea, mild/moderate prevalence was 30% and incidence 2 events per person-year, and severe prevalence was 5% and incidence 0.01 events per person-year. A similar prevalence of 5% was found for treatment regimes that did not include sulphonylureas. Conclusions Current evidence shows hypoglycaemia is considerably prevalent amongst people with type 2 diabetes, particularly for those on insulin, yet still fairly common for other treatment regimens. This highlights the subsequent need for educational interventions and individualisation of therapies to reduce the risk of hypoglycaemia.
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