Diabetes progression and severe hypoglycemia: a nationwide cohort study of 2,475,605 adults with type 2 diabetes mellitus.

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Korean Journal of Internal Medicine Pub Date : 2026-09-01 DOI:10.3904/kjim.2026.084

Kyu-Na Lee, Bongseong Kim, Mee Kyoung Kim, Sukil Kim

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引用次数: 0

Abstract

Background/aims: Severe hypoglycemia (SH) is a major concern in type 2 diabetes mellitus (T2DM). We evaluated whether a composite diabetes progression score could predict incident SH.

Methods: Using the Korean National Health Insurance Service database, we identified 2,475,605 adults with T2DM who underwent health examinations in 2015-2016. Incident SH was defined by ICD-10 codes plus emergency department visit or hospitalization. The progression score (range, 0-6) comprised six indicators: longer diabetes duration, use of ≥ 3 oral glucose-lowering drug classes, insulin use, chronic kidney disease (CKD), cardiovascular disease, and diabetic retinopathy.

Results: During 1 year of follow-up, 1,186 SH events occurred. Each component of diabetes progression was independently insuassociated with SH risk hazard ratios (HRs) from 1.19-3.27, with insulin use and CKD showing the largest effects. SH risk increased stepwise with higher progression scores. Compared with a score of 0, the adjusted HRs (95% confidence intervals) were 3.35 (2.63-4.27), 7.74 (6.15-9.74), 12.61 (9.97-15.95), 22.39 (17.44-28.75) for scores 1, 2, 3, and ≥ 4, respectively.

Conclusion: A concise diabetes progression score strongly stratified short-term SH risk in this nationwide cohort, and may help target proactive prevention and early intervention.

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糖尿病进展和严重低血糖：一项2475605名成人2型糖尿病患者的全国性队列研究

背景/目的：严重低血糖（SH）是2型糖尿病（T2DM）的主要问题。我们评估了复合糖尿病进展评分是否可以预测sh的发生。方法：使用韩国国民健康保险服务数据库，我们确定了2015-2016年接受健康检查的2,475,605名成年T2DM患者。事件SH由ICD-10代码加上急诊或住院来定义。进展评分（范围0-6）包括6个指标：糖尿病持续时间更长，使用≥3种口服降糖药物，胰岛素使用，慢性肾脏疾病（CKD），心血管疾病和糖尿病视网膜病变。结果：在1年的随访中，发生了1186例SH事件。糖尿病进展的每个组成部分与SH风险风险比（hr）独立相关，范围为1.19-3.27，其中胰岛素使用和CKD的影响最大。随着进展分数的提高，SH风险逐渐增加。与0分相比，1分、2分、3分和≥4分的调整hr（95%置信区间）分别为3.35（2.63 ~ 4.27）、7.74（6.15 ~ 9.74）、12.61（9.97 ~ 15.95）、22.39（17.44 ~ 28.75）。结论：在这个全国性队列中，简明的糖尿病进展评分有力地分层了短期SH风险，并可能有助于目标的积极预防和早期干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Korean Journal of Internal Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

5.10

自引率

4.20%

发文量

129

审稿时长

20 weeks

期刊介绍： The Korean Journal of Internal Medicine is an international medical journal published in English by the Korean Association of Internal Medicine. The Journal publishes peer-reviewed original articles, reviews, and editorials on all aspects of medicine, including clinical investigations and basic research. Both human and experimental animal studies are welcome, as are new findings on the epidemiology, pathogenesis, diagnosis, and treatment of diseases. Case reports will be published only in exceptional circumstances, when they illustrate a rare occurrence of clinical importance. Letters to the editor are encouraged for specific comments on published articles and general viewpoints.