title: Predictors for Mild and Severe Hypoglycemia in Insulin-Treated Japanese Diabetic Patients.
abstract: The objective of this study was to explore predictors, including social factors, lifestyle factors, and factors relevant to glycemic control and treatment, for mild and severe hypoglycemia in insulin-treated Japanese diabetic patients. This study included 123 insulin-treated diabetic patients who were referred to the diabetes clinic between January and July 2013 at Shiga University of Medical Science Hospital. After a survey examining the various factors, patients were followed for 6 months. During the follow-up period, blood glucose was self-monitored. Mild hypoglycemia was defined as blood glucose level 50-69 mg/dl, and severe hypoglycemia was defined as blood glucose level ≤49 mg/dl. Multinomial logistic regression was used to estimate the adjusted odds ratio (OR) and 95% confidence interval (CI) of each factor for mild and severe hypoglycemia. During the 6-month follow-up period, 41 (33.3%) patients experienced mild hypoglycemia, and 20 (16.3%) experienced severe hypoglycemia. In multivariable-adjusted analyses, assistance from family members at the time of the insulin injection [presence/absence, OR (95% CI): 0.39 (0.16-0.97)] and drinking [current drinker/non- and ex-drinker, OR (95% CI): 4.89 (1.68-14.25)] affected mild hypoglycemia. Assistance from family members at the time of insulin injection [presence/absence, OR (95% CI): 0.19 (0.05-0.75)] and intensive insulin therapy [yes/no, OR (95% CI): 3.61 (1.06-12.26)] affected severe hypoglycemia. In conclusion, our findings suggest that not only a factor relevant to glycemic control and treatment (intensive insulin therapy) but also a social factor (assistance from family members) and a lifestyle factor (current drinking) were predictors for mild or severe hypoglycemia in Japanese insulin-treated diabetic patients.
authors.affiliation: Department of Clinical Nursing, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Nao
authors.initials: N
authors.lastname: Sonoda
authors.affiliation: Department of Clinical Nursing, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Morimoto
authors.affiliation: Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ugi
authors.affiliation: Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Katsutaro
authors.initials: K
authors.lastname: Morino
authors.affiliation: Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Sekine
authors.affiliation: Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Nemoto
authors.affiliation: Department of Clinical Nursing, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Godai
authors.affiliation: Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maegawa
authors.affiliation: Department of Clinical Nursing, Shiga University of Medical Science, Otsu, Shiga, Japan.
authors.forename: Naomi
authors.initials: N
authors.lastname: Miyamatsu
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000097:blood; D000886:Anthropometry; D015190:Blood Glucose Self-Monitoring; D017028:Caregivers; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D004522:Educational Status; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006184:Habits; D019538:Health Care Surveys; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D007564:Japan; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin