title: Antidiabetic pharmacotherapy and anamnestic hypoglycemia in a large cohort of type 2 diabetic patients--an analysis of the DiaRegis registry.
abstract: BACKGROUND
  We aimed to identify predictors of anamnestic hypoglycaemia in type-2 diabetic patients on oral mono- or dual oral combination antidiabetic pharmacotherapy.
  
  
  METHODS
  DiaRegis is a prospective registry in type-2 diabetic patients in primary care. Odds ratios (OR) with 95% confidence intervals were determined from univariate logistic regression. Using multivariate logistic regression analysis with stepwise backward selection at an alpha of 0.05 independent predictors of hypoglycaemia were determined.
  
  
  RESULTS
  3,808 patients had data on hypoglycaemia available (median age 65.9 years, 46.6% female). 10.8% had at least one anamnestic hypoglycaemic episode within the previous 12 months. Patients with hypoglycaemia received more sulfonylureas (OR 2.16; 95%CI 1.75-2.67) and less metformin (OR 0.64; 95%CI 0.50-0.82). On top of metformin, patients with thiazolidine (OR 0.50; 95%CI 0.28-0.89) and DPP-4 inhibitor use (OR 0.34; 95%CI 0.16-0.70) had a decreased risk for hypoglycaemia while it was again increased with sulfonylureas (OR 2.08; 95%CI 1.44-2.99). Age < 65 years was an independent predictor of a reduced hypoglycaemia incidence (OR 0.76; 95%CI 0.59-0.96), low HbA1c (OR 1.68; 95%CI 1.31-2.14), stroke/TIA (OR 1.72; 95%CI 1.08-2.72), heart failure (OR 1.77; 95%CI 1.28-2.45), and the use of sulfonylureas (OR 2.58; 95%CI 2.03-3.29) were independent predictors of increased risk.
  
  
  CONCLUSIONS
  The results indicate that the risk of hypoglycaemia might be substantially reduced by carefully selecting antidiabetic pharmacotherapy in patients with type-2 diabets in primary care.
authors.affiliation: Herz- und Diabeteszentrum Nordrhein-Westfalen in Bad Oeynhausen, Universitätsklinik der Ruhr Universität, Bochum, Germany. diethelm.tschoepe@ruhr-uni-bochum.de
authors.forename: Diethelm
authors.initials: D
authors.lastname: Tschöpe
authors.forename: Peter
authors.initials: P
authors.lastname: Bramlage
authors.forename: Christiane
authors.initials: C
authors.lastname: Binz
authors.forename: Michael
authors.initials: M
authors.lastname: Krekler
authors.forename: Tanja
authors.initials: T
authors.lastname: Plate
authors.forename: Evelin
authors.initials: E
authors.lastname: Deeg
authors.forename: Anselm K
authors.initials: AK
authors.lastname: Gitt
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D004358:Drug Therapy / Q000379:methods*; D004359:Drug Therapy, Combination; D005260:Female; D005858:Germany / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006333:Heart Failure / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology*; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents