title: Association between hypoglycaemia and impaired hypoglycaemia awareness and mortality in people with Type 1 diabetes mellitus.
abstract: OBJECTIVE
  To examine whether severe hypoglycaemia and impaired hypoglycaemic awareness, a principal predictor of severe hypoglycaemia, are associated with all-cause mortality or cardiovascular mortality in Type 1 diabetes mellitus.
  
  
  METHODS
  Mortality was recorded in two cohorts, one in Denmark (n = 269, follow-up 12 years) and one in the Netherlands (n = 482, follow-up 6.5 years). In both cohorts, awareness class was characterized and numbers of episodes of severe hypoglycaemia either during lifetime (Danish cohort) or during the preceding year (Dutch cohort) were recorded. In addition, episodes of severe hypoglycaemia were prospectively recorded every month for 1 year in the Danish cohort. Follow-up data regarding mortality were obtained through medical reports and registries (Danish cohort).
  
  
  RESULTS
  All-cause mortality was 14% (n = 39) in the Danish and 4% (n = 20) in the Dutch cohort. In either cohort, neither presence of episodes with severe hypoglycaemia nor impaired hypoglycaemia awareness were associated with increased mortality in age-truncated Cox proportional hazard regression models. Variables associated with increased risk of all-cause mortality in both cohorts were evidence of macrovascular disease and reduced kidney function.
  
  
  CONCLUSIONS
  Severe hypoglycaemia and hypoglycaemia unawareness are not associated with increased risk of all-cause or cardiovascular mortality in people with Type 1 diabetes mellitus.
authors.affiliation: Department of Cardiology, Nephrology and Endocrinology, Nordsjaellands University Hospital, Hillerød, Denmark.|Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
authors.forename: A-S
authors.initials: AS
authors.lastname: Sejling
authors.affiliation: Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: Schouwenberg
authors.affiliation: Department of Cardiology, Nephrology and Endocrinology, Nordsjaellands University Hospital, Hillerød, Denmark.
authors.forename: L H
authors.initials: LH
authors.lastname: Faerch
authors.affiliation: Department of Cardiology, Nephrology and Endocrinology, Nordsjaellands University Hospital, Hillerød, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: B
authors.initials: B
authors.lastname: Thorsteinsson
authors.affiliation: Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: B E
authors.initials: BE
authors.lastname: de Galan
authors.affiliation: Department of Cardiology, Nephrology and Endocrinology, Nordsjaellands University Hospital, Hillerød, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: U
authors.initials: U
authors.lastname: Pedersen-Bjergaard
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D058065:Diabetic Cardiomyopathies / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D003928:Diabetic Nephropathies / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D059026:Diagnostic Self Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009426:Netherlands / Q000453:epidemiology; D010044:Outpatient Clinics, Hospital; D015995:Prevalence; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis