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©The Author(s) 2015.
World J Diabetes. Feb 15, 2015; 6(1): 30-36
Published online Feb 15, 2015. doi: 10.4239/wjd.v6.i1.30
Published online Feb 15, 2015. doi: 10.4239/wjd.v6.i1.30
Table 1 Published articles about the drug-induced hypoglycemia in patients with diabetes
| Ref. | Subjects | Year | Nation | Setting | OAD | Insulin | Combination |
| Kim et al[27] | Type 2 (n = 298) | 2004-2009 | South Korea | The Emergency Department of two general hospitals | Glimepiride (24.2%) Gliclazide (5.4%) Glibenclamide (8.4%) | NPH/RI (38.3%) Premixed (11.1%) Glargine/Detemir (13.1%) | |
| Tsujimoto et al[28] | Type 1 (n = 85) | 2006-2012 | Japan | Retrospective cohort study in one medical center | Insulin (100%) | ||
| Type 2 (n = 305) | SU (42.3%) Others (6.6%) | Insulin (51.1%) | |||||
| Signorovitch et al[29] | Type 2 not treated with insulin (n = 5582) | 1998-2010 | United States | US-based employer claims database | SU (38.2%) Biguanides (56.3%) a-GI (0.9%) Sitagliptin (1.0%) Incretin mimetics (0.5%) TZD (14.9%) | ||
| Moisan et al[30] | Not determined (n = 3575) | 2000-2008 | Canada | Inception cohort study using the database of the Quebec health insurance board and the Quebec registry of hospitalizations | SU (32.1%) Metformin (45.0%) SU + Metformin (12.3%) Others (2.1%) | Insulin (8.5%) | |
| Hsu et al[31] | Type 2 (n = 500) | 1998-2009 | Taiwan | A nationwide population-based study using the National Health Insurance Research Database | SU (67.8%) Others (61.4%) | Insulin (24.2%) | |
| Holstein et al[32] | Type 1 (n = 92) | 1997-2000 | German | A longitudinal population-based study | Conventional (27.2%) Intensified (69.6%) CSII (3.3%) | ||
| Type 1 (n = 121) | 2007-2010 | Conventional (6.6%) Intensified (79.3%) CSII (13.2%) | |||||
| Type 2 (n = 148) | 1997-2000 | SU (30.4%) | Conventional (52.7%) Intensified (0%) CSII (0%) | SU + Insulin (16.9%) | |||
| Type 2 (n = 225) | 2007-2010 | SU (29.8%) Metformin (0.9%) | Conventional (40.8%) Intensified (21.8%) CSII (0%) | SU + Insulin (6.7%) | |||
| Ha et al[33] | Not determined (n = 320) | 2006-2009 | South Korea | Retrospective analysis of hypoglycemic patients presented to emergency room of Uijeongbu St. Mary’s Hospital | Glimepiride (29.7%) Glibenclamide (4.7%) Gliclazide (4.7%) Gliquidone (1.3%) Glipizide (0.9%) Others (24.7%) | Insulin (29.1%) | SU + Insulin (5.0%) |
| Geller et al[34] | Not determined (n = 8100) | 2007-2011 | United States | Nationally representative public health surveillance of adverse drug events among insulin-treated patients seeking emergency department care | Insulin (83.4%) | Insulin + Biguanide (8.5%) SU (6.6%) TZD (3.6%) DPP-4 inhibitors (1.3%) GLP-1 analogues (0.2%) Others (0.9%) | |
| Ben-Ami et al[35] | Type 1 and 2 (n = 99) | 1986-1992 | Israel | Retrospective analysis of the medical record in Rambam Medical Center | Glyburide (51.5%) Glyburide + Metformin (10.2%) | Insulin (23.2%) | Insulin + Glyburide (13.1%) Insulin + Metformin (2.0%) |
| Quilliam et al[36] | Type 2 (n = 536581) | 2004-2008 | United States | Retrospective cohort designed to assess the rate and costs of hypoglycemia among working-age patients with type 2 diabetes in the MarketScan database | SU (42.3%) Metformin (75.7%) TZD (33.3%) Other oral agents (4.4%) | Insulin (6.0%) Other injectable agents (2.7%) | |
| Parsaik et al[37] | Type 1 (n = 210) | 2003-2009 | United States | Population-basedstudy | Simple insulin (10.0%) MDI (67.0%) CSII(18.0%) | OAD + Insulin (1.0%) | |
| Type 2 (n = 503) | OAD (23.0%) | Simple insulin (27.0%) MDI (37.0%) CSII (1.0%) | OAD + Insulin(11.0%) |
Table 2 Published articles about the underlying clinical factors for the development of hypoglycemia in patients with diabetes
| Ref. | Clinical factors | Hypoglycemia | No hypoglycemia | P value |
| Yaffe et al[49] | Black race/ethnicity (%) | 72.1 | 44.9 | < 0.01 |
| Education (< high school education) (%) | 36.1 | 24.0 | 0.04 | |
| Glycated hemoglobin level (%) | 8.0 | 7.2 | < 0.01 | |
| Prevalent diabetes mellitus (%) | 85.2 | 47.9 | < 0.01 | |
| MMSE score [mean (SD)] | 89.6 (5.7) | 91.5 (5.2) | < 0.01 | |
| Hsu et al[31] | Hypertension (%) | 63.6 | 51.2 | < 0.0001 |
| Liver cirrhosis (%) | 3.0 | 1.3 | 0.0074 | |
| Renal disease (%) | 17.4 | 5.2 | < 0.0001 | |
| Mental disease (%) | 21.4 | 12.5 | < 0.0001 | |
| Cancer (%) | 8.0 | 2.4 | < 0.0001 | |
| Stroke (%) | 15.0 | 4.0 | < 0.0001 | |
| Heart disease (%) | 13.2 | 3.6 | < 0.0001 | |
| Leese et al[51] | Age (mean, yr) | |||
| Type 1 treated with insulin | 37.7 | 32.8 | 0.009 | |
| Type 2 treated with insulin | 66.6 | 63.2 | 0.038 | |
| Diabetes duration (mean, years) | ||||
| Type 1 treated with insulin | 20.7 | 16.7 | 0.013 | |
| BMI (mean, kg/m2) | ||||
| Type 2 treated with insulin | 26.7 | 30.1 | < 0.001 | |
| Signorovitch et al[29] | Mental disorders (%) | 15.2 | 11.4 | < 0.001 |
| Neurological disorders (%) | 17.2 | 10.7 | < 0.001 | |
| Cardiovascular disorders (%) | 60.4 | 59.0 | 0.05 | |
| Renal disorders (%) | 16.5 | 12.3 | < 0.001 | |
| Epilepsy (%) | 1.2 | 0.7 | < 0.001 | |
| Stroke (%) | 4.9 | 2.9 | < 0.001 | |
| CCI [mean (SD)] | 1.42 (1.70) | 1.3 | < 0.001 | |
| Punthakee et al[50] | Age [yr, mean (SD)] | 63.91 (6.41) | 62.41 (5.77) | 0.002 |
| Female (%) | 55.6 | 46.1 | 0.019 | |
| Race | < 0.0001 | |||
| Non-Hispanic white (%) | 60.0 | 70.9 | ||
| African American (%) | 30.0 | 15.4 | ||
| Hispanic (%) | 6.3 | 7.1 | ||
| Others (%) | 3.8 | 6.6 | ||
| Education | ||||
| Less than high school (%) | 16.3 | 12.8 | ||
| High school graduate (%) | 35.0 | 25.2 | ||
| Some college (%) | 26.9 | 35.1 | 0.01 | |
| College graduate (%) | 21.9 | 26.9 | ||
| BMI [mean (SD), kg/m2] | 32.08 (5.64) | 33.03 (5.33) | 0.029 | |
| Diabetes duration [mean (SD) of years] | 14.13 (8.74) | 10.18 (7.22) | < 0.0001 | |
| HbA1c (%) | 8.46 (1.06) | 8.27 (1.05) | 0.021 | |
| History of stroke (%) | 11.3 | 4.6 | 0.0002 | |
| History of cardiovascular disease (%) | 41.9 | 28.4 | 0.0003 | |
| Neuropathy score [mean (SD)] | 0.53 (0.50) | 0.45 (0.50) | 0.049 | |
| UACR (mg/mmol) | < 0.0001 | |||
| < 30 (%) | 58.8 | 72.4 | ||
| 30-300 (%) | 27.5 | 21.9 | ||
| > 300 (%) | 13.8 | 5.7 | ||
| DSST score [mean (SD)] | 46.45 (17.01) | 52.89 (15.76) | < 0.0001 | |
| RAVLT score [mean (SD)] | 6.90 (2.72) | 7.55 (2.53) | 0.002 | |
| Stroop score [mean (SD)] | 37.69 (22.02) | 31.66 (16.25) | < 0.0001 | |
| MMSE score [mean (SD)] | 26.83 (2.80) | 27.45 (2.49) | 0.002 |
Table 3 Summary of the underlying clinical factors for the development of hypoglycemia in patients with diabetes
| 1 Socioeconomic status (education, race) |
| 2 Aging |
| 3 State of diabetes (duration, HbA1c, body mass index) |
| 4 Cognitive and mental function |
| 5 Comorbidity |
| 6 Failure of organ which influence on clearance of insulin and oral anti-diabetic drugs (Heart, liver, renal failure) |
| 7 Hypoglycemia-associated autonomic failure |
- Citation: Yanai H, Adachi H, Katsuyama H, Moriyama S, Hamasaki H, Sako A. Causative anti-diabetic drugs and the underlying clinical factors for hypoglycemia in patients with diabetes. World J Diabetes 2015; 6(1): 30-36
- URL: https://www.wjgnet.com/1948-9358/full/v6/i1/30.htm
- DOI: https://dx.doi.org/10.4239/wjd.v6.i1.30