title: Prevalence and Incidence of Hypoglycaemia in 532,542 People with Type 2 Diabetes on Oral Therapies and Insulin: A Systematic Review and Meta-Analysis of Population Based Studies.
abstract: OBJECTIVE
  To collate and evaluate the current literature reporting the prevalence and incidence of hypoglycaemia in population based studies of type 2 diabetes.
  
  
  METHODS
  Medline, Embase and Cochrane were searched up to February 2014 to identify population based studies reporting the proportion of people with type 2 diabetes experiencing hypoglycaemia or rate of events experienced. Two reviewers independently screened studies for eligibility and extracted data for included studies. Random effects meta-analyses were carried out to calculate the prevalence and incidence of hypoglycaemia.
  
  
  RESULTS
  46 studies (n = 532,542) met the inclusion criteria. Prevalence of hypoglycaemia was 45% (95%CI 0.34,0.57) for mild/moderate and 6% (95%CI, 0.05,0.07) for severe. Incidence of hypoglycaemic episodes per person-year for mild/moderate and for severe was 19 (95%CI 0.00, 51.08) and 0.80 (95%CI 0.00,2.15), respectively. Hypoglycaemia was prevalent amongst those on insulin; for mild/moderate episodes the prevalence was 50% and incidence 23 events per person-year, and for severe episodes the prevalence was 21% and incidence 1 event per person-year. For treatment regimes that included a sulphonylurea, mild/moderate prevalence was 30% and incidence 2 events per person-year, and severe prevalence was 5% and incidence 0.01 events per person-year. A similar prevalence of 5% was found for treatment regimes that did not include sulphonylureas.
  
  
  CONCLUSIONS
  Current evidence shows hypoglycaemia is considerably prevalent amongst people with type 2 diabetes, particularly for those on insulin, yet still fairly common for other treatment regimens. This highlights the subsequent need for educational interventions and individualisation of therapies to reduce the risk of hypoglycaemia.
authors.affiliation: University of Leicester, Department of Health Sciences, Leicester Diabetes Centre, Leicester General Hospital, Leicester, United Kingdom.
authors.forename: Chloe L
authors.initials: CL
authors.lastname: Edridge
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, United Kingdom.
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Dunkley
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, United Kingdom.
authors.forename: Danielle H
authors.initials: DH
authors.lastname: Bodicoat
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, United Kingdom.
authors.forename: Tanith C
authors.initials: TC
authors.lastname: Rose
authors.affiliation: University of Leicester, Department of Health Sciences, University Road, Leicester, United Kingdom.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Gray
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, United Kingdom.
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Davies
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, United Kingdom.
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Khunti
mesh_terms: D000284:Administration, Oral; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007003:Hypoglycemia / Q000150:complications / Q000453:epidemiology*; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015994:Incidence; D007328:Insulin / Q000627:therapeutic use*; D015995:Prevalence
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin