Severe hypoglycaemia not linked to HbA1c

Type 1 diabetes

8 Oct 2015

Rates of severe hypoglycaemia in young people with type 1 diabetes are not linked to HbA1c but more to the treatment regimen used, an analysis of three paediatric diabetes cohorts concludes.

Analysing data from the US T1D Exchange, the German/Austrian DPV, and the Australian WACDD  registries the researchers found that rates of severe hypoglycaemia were lower in patients treated with insulin pumps compared to injections.

In both groups of patients rates of severe hypoglycaemia, categorised as coma and/or convulsion, were not related to HbA1c.

Presenting the findings during the session on diabetes treatments and technology Dr Aveni Haynes a research fellow from the Telethon Kids Institute in Western Australia said the results supported the use of CSII in minimizing severe hypoglycaemia in paediatric patients with type 1 diabetes.

The analysis involved patients with type 1 diabetes from the US T1D Exchange (n=7,102) the German/Austrian DPV (n= 21,724) and Australian WACDD (n=943) registries who were seen over a 12 month period.

Overall, 60% of patients were treated with CSII in T1DX, 40% in DPV and 35% in WACDD.

Severe hypoglycaemia rates per 100 patient years was 7.1, 3.2, and 7.6 in T1DX, DPV and WACDD patients, respectively.

After adjusting for sex, age, duration of diabetes and HbA1c the SH rate was 26% (p=0.005) higher in T1DX and 35% (p< 0.0001) higher in DPV patients on injections compared to CSII. However no significant difference was observed in the smaller WACDD cohort.

Translating the data into clinical practice and patient education may reduce the fear of hypoglyacemia and optimize glycaemic control, Dr Haynes told delegates.

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