Katarina Eeg-Olofsson, David Nathanson, Tim Spelman, Mattias Kyhlstedt, Alexander Seibold, Fleur Levrat-Guillen, Jan Bolinder
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We identified people with type 1 diabetes who had a hospitalisation for CVD complications. Rates of hospitalisation were compared between those with an index SHE and those without, and within isCGM or BGM subgroups. The study baseline was date of the first SHE prior to the isCGM index date.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>We identified 14,829 adults with type 1 diabetes with up to 2 years of follow-up, of which 1313 had an index SHE. In the full cohort, the relative rate of hospitalisations for CVD complications was 2.06-fold (95% CI 1.48, 2.85) in those with prior SHE. Of these 1313 participants with prior SHE, 970 were using isCGM and 343 were using BGM. Hospitalisations for post-SHE CVD complications were significantly lower for isCGM users (5.40 per 100 person-years of follow-up; 95% CI 4.59, 6.31) compared with BGM control participants (14.23 per 100 person-years of follow-up; 95% CI 11.95, 16.82), which represents a 78% relative reduction in rates of post-SHE CVD complications for isCGM users (relative rate 0.22; 95% CI 0.11, 0.43; <i>p</i><0.001), after adjustment for confounders.</p><h3 data-test=\"abstract-sub-heading\">Conclusions/interpretation</h3><p>In adults with type 1 diabetes, SHE is associated with an increased risk of hospitalisation for adverse CVD complications. This risk is significantly reduced in isCGM users compared with BGM control participants.</p><h3 data-test=\"abstract-sub-heading\">Graphical Abstract</h3>\n","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":"6 1","pages":""},"PeriodicalIF":8.4000,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Severe hypoglycaemia is associated with increased risk of adverse cardiovascular complications in adults with type 1 diabetes: risk mitigation using intermittently scanned continuous glucose monitoring\",\"authors\":\"Katarina Eeg-Olofsson, David Nathanson, Tim Spelman, Mattias Kyhlstedt, Alexander Seibold, Fleur Levrat-Guillen, Jan Bolinder\",\"doi\":\"10.1007/s00125-025-06438-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Aims/hypothesis</h3><p>It has been proposed that severe hypoglycaemia events (SHE) may increase the risk of adverse CVD complications in adults with type 1 diabetes. The aim of this study was to evaluate the risk of CVD complications following SHE in a large cohort of adults with type 1 diabetes, and to compare the risk of post-SHE CVD complications for users of intermittently scanned continuous glucose monitoring (isCGM) vs users of blood glucose monitoring (BGM).</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>This comparative retrospective cohort study used data from the Swedish National Diabetes Register and the Swedish National Patient Register. We identified people with type 1 diabetes who had a hospitalisation for CVD complications. Rates of hospitalisation were compared between those with an index SHE and those without, and within isCGM or BGM subgroups. The study baseline was date of the first SHE prior to the isCGM index date.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>We identified 14,829 adults with type 1 diabetes with up to 2 years of follow-up, of which 1313 had an index SHE. In the full cohort, the relative rate of hospitalisations for CVD complications was 2.06-fold (95% CI 1.48, 2.85) in those with prior SHE. Of these 1313 participants with prior SHE, 970 were using isCGM and 343 were using BGM. Hospitalisations for post-SHE CVD complications were significantly lower for isCGM users (5.40 per 100 person-years of follow-up; 95% CI 4.59, 6.31) compared with BGM control participants (14.23 per 100 person-years of follow-up; 95% CI 11.95, 16.82), which represents a 78% relative reduction in rates of post-SHE CVD complications for isCGM users (relative rate 0.22; 95% CI 0.11, 0.43; <i>p</i><0.001), after adjustment for confounders.</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusions/interpretation</h3><p>In adults with type 1 diabetes, SHE is associated with an increased risk of hospitalisation for adverse CVD complications. 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引用次数: 0
摘要
目的/假设已经提出，严重低血糖事件（SHE）可能会增加成人1型糖尿病患者不良CVD并发症的风险。本研究的目的是评估一大批成人1型糖尿病患者SHE后CVD并发症的风险，并比较间歇性扫描连续血糖监测（isCGM）和血糖监测（BGM）用户SHE后CVD并发症的风险。方法：本比较回顾性队列研究使用瑞典国家糖尿病登记和瑞典国家患者登记的数据。我们确定了因心血管疾病并发症住院治疗的1型糖尿病患者。比较有SHE指数者与无SHE指数者的住院率，以及isCGM或BGM亚组的住院率。研究基线是在isCGM索引日期之前的第一次SHE日期。结果我们对14829名成人1型糖尿病患者进行了长达2年的随访，其中1313人有SHE指数。在整个队列中，既往SHE患者因CVD并发症住院的相对比率为2.06倍（95% CI 1.48, 2.85）。在这1313名既往患有SHE的参与者中，970人使用isCGM， 343人使用BGM。isCGM使用者因she后心血管疾病并发症住院的人数显著降低(5.40 / 100人-年随访；95% CI 4.59, 6.31)与BGM对照组相比(14.23 / 100人-年随访；95% CI 11.95, 16.82)，这表明isCGM使用者的she后心血管疾病并发症发生率相对降低了78%(相对率0.22；95% ci 0.11, 0.43；P<0.001)，校正混杂因素后。结论/解释在成人1型糖尿病患者中，SHE与不良CVD并发症住院风险增加相关。与BGM对照组相比，isCGM使用者的这种风险显著降低。图形抽象
Severe hypoglycaemia is associated with increased risk of adverse cardiovascular complications in adults with type 1 diabetes: risk mitigation using intermittently scanned continuous glucose monitoring
Aims/hypothesis
It has been proposed that severe hypoglycaemia events (SHE) may increase the risk of adverse CVD complications in adults with type 1 diabetes. The aim of this study was to evaluate the risk of CVD complications following SHE in a large cohort of adults with type 1 diabetes, and to compare the risk of post-SHE CVD complications for users of intermittently scanned continuous glucose monitoring (isCGM) vs users of blood glucose monitoring (BGM).
Methods
This comparative retrospective cohort study used data from the Swedish National Diabetes Register and the Swedish National Patient Register. We identified people with type 1 diabetes who had a hospitalisation for CVD complications. Rates of hospitalisation were compared between those with an index SHE and those without, and within isCGM or BGM subgroups. The study baseline was date of the first SHE prior to the isCGM index date.
Results
We identified 14,829 adults with type 1 diabetes with up to 2 years of follow-up, of which 1313 had an index SHE. In the full cohort, the relative rate of hospitalisations for CVD complications was 2.06-fold (95% CI 1.48, 2.85) in those with prior SHE. Of these 1313 participants with prior SHE, 970 were using isCGM and 343 were using BGM. Hospitalisations for post-SHE CVD complications were significantly lower for isCGM users (5.40 per 100 person-years of follow-up; 95% CI 4.59, 6.31) compared with BGM control participants (14.23 per 100 person-years of follow-up; 95% CI 11.95, 16.82), which represents a 78% relative reduction in rates of post-SHE CVD complications for isCGM users (relative rate 0.22; 95% CI 0.11, 0.43; p<0.001), after adjustment for confounders.
Conclusions/interpretation
In adults with type 1 diabetes, SHE is associated with an increased risk of hospitalisation for adverse CVD complications. This risk is significantly reduced in isCGM users compared with BGM control participants.
期刊介绍：
Diabetologia, the authoritative journal dedicated to diabetes research, holds high visibility through society membership, libraries, and social media. As the official journal of the European Association for the Study of Diabetes, it is ranked in the top quartile of the 2019 JCR Impact Factors in the Endocrinology & Metabolism category. The journal boasts dedicated and expert editorial teams committed to supporting authors throughout the peer review process.
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