Recent evidence suggests severe hypoglycaemia may pose a risk of premature mortality to individuals with type 2 diabetes. Evidence surrounding strategies to mitigate this risk is currently lacking as is evidence regarding risk stratification of such patients.
We performed a post-hoc analysis from a previously published RCT studying the impact of a structured nurse led intervention following severe hypoglycaemia. A Cox regression model was used to identify baseline characteristics associated with increased mortality and to adjust for differences between study groups. Kaplan Meier (KM) curves were created to demonstrate differences in outcome between study groups across a number of variables.
124 participants (mean age 75, 57% male) were included in analysis. Diabetes severity score, age and insulin use were found to correlate with mortality, while other variables including HbA1c and presence of established cardiovascular disease showed no correlations. When comparing KM curves between study groups, the intervention appeared to be beneficial irrespective of glycaemic control, presence of vascular disease, diabetes severity score or age.
In this analysis, only diabetes severity score, age and insulin use were significantly associated with death following severe hypoglycaemia in the community. A structured nurse-led intervention appears to reduce the risk of death irrespective of age, co-morbidities or type of treatment.
Data is taken from a previously published randomised controlled trial with trial registration NCT04422145.