title: Hemoglobin A(1c) proportion, mortality rate, and risk factors for death in diabetic patients with severe hypoglycemia: a multicenter retrospective survey over ten years.
abstract: OBJECTIVE
  To investigate the HbA(1c) proportion and mortality rate across diabetic patients with severe hypoglycemia and the risk factors for death.
  
  
  METHODS
  All the diabetic patients with severe hypoglycemia were divided into HbA(1c)<6.5% group and HbA(1c)≥6.5% group. The proportion of HbA(1c), mortality rate and the risk factors for death were analyzed. Common causes for severe hypoglycemia were also analyzed.
  
  
  RESULTS
  The percentages of HbA(1c) in the HbA(1c)<6.5% and HbA(1c)≥6.5% groups were 51.2% and 48.8%, respectively. The mortality rates were not significantly different between the 2 groups (5.3% vs. 5.1%, χ(2)=0.01, p=0.17). Binary logistic regression analysis revealed that in both groups, creatinine, aspartate aminotransferase, and uric acid levels were the risk factors for death. In the HbA(1c)<6.5% and HbA(1c)≥6.5% groups, 65.0% and 64.2% showed common causes of severe hypoglycemia, respectively.
  
  
  CONCLUSIONS
  With respect to severe hypoglycemia, equal attention should be paid to patients with an HbA(1c) level of ≥6.5% and those with an HbA(1c) level of <6.5%. The mortality rate is approximately 5% in severe hypoglycemia no matter how the HbA(1c) level is. Creatinine, aspartate aminotransferase, and uric acid are the main risk factors in both groups. Two-thirds of severe hypoglycemia cases could be prevented.
authors.affiliation: Department of Endocrinology, The Second Affiliated Hospital, Guangzhou Medical University, 250 Changgang Donglu, Guangzhou 510260, China. liwg660@126.com
authors.forename: Wan-gen
authors.initials: WG
authors.lastname: Li
authors.forename: Xin-lian
authors.initials: XL
authors.lastname: He
authors.forename: Tong
authors.initials: T
authors.lastname: Zhang
authors.forename: Guang-da
authors.initials: GD
authors.lastname: Xiang
authors.forename: Jian-min
authors.initials: JM
authors.lastname: Ran
authors.forename: Cheng
authors.initials: C
authors.lastname: Peng
authors.forename: Hong
authors.initials: H
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001219:Aspartate Aminotransferases / Q000378:metabolism; D003404:Creatinine / Q000378:metabolism; D003920:Diabetes Mellitus / Q000378:metabolism* / Q000401:mortality*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007003:Hypoglycemia / Q000378:metabolism* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014527:Uric Acid / Q000378:metabolism
chemical_list: D001219:Aspartate Aminotransferases; D003404:Creatinine; D006442:Glycated Hemoglobin; D014527:Uric Acid