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Year : 2018  |  Volume : 22  |  Issue : 3  |  Page : 379-386

The incidence of hypoglycemia among insulin-treated patients with Type 1 or Type 2 diabetes: Bangladeshi cohort of international operations-hypoglycemia assessment tool study

1 Department of Medicine and Endocrinology, BIRDEM General Hospital, Chittagong, Bangladesh
2 Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Chittagong, Bangladesh
3 Department of Medicine, Bangladesh University of Health Sciences, Dhaka, Bangladesh
4 Department of Endocrinology, Chittagong Medical College Hospital, Chittagong, Bangladesh
5 Department of Endocrinology, Mymensingh Medical College and Hospital, Mymensingh, Bangladesh
6 Department of Endocrinology, Square Hospital, Dhaka, Bangladesh
7 Department of Endocrinology, Popular Medical College Hospital, Dhaka, Bangladesh
8 Department of Endocrinology, Dhaka Medical College and Hospital, Dhaka, Bangladesh
9 Department of Endocrinology, BIRDEM General Hospital, Dhaka, Bangladesh
10 Department of Clinical, Medical, Regulatory & Quality, Novo Nordisk Pharma (Private) Limited, Dhaka, Bangladesh

Correspondence Address:
Md. Faruque Pathan
Department of Medicine and Endocrinology, BIRDEM General Hospital, East Shawrapara, Mirpur, Dhaka 1216
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijem.IJEM_545_17

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Objectives: The objective of this study was to assess the incidence of hypoglycemia in patients with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) in Bangladeshi cohort of the International Operations-Hypoglycemia Assessment Tool study. Materials and Methods: Patients diagnosed with either T1DM or T2DM, aged ≥18 years, treated with insulin (any regimen) for >12 months, and completed self-assessment questionnaires (SAQs) to record demography, treatment information, and hypoglycemia during the 6-month retrospective and 4-week prospective periods (a total of 7 months) were enrolled in the study. Results: A total of 1179 patients were enrolled and completed the SAQ1 (T1DM, n = 25; T2DM, n = 1154). Almost all patients (T1DM: 100.0% [95% confidence interval (CI): 86.3%, 100.0%] and T2DM: 97.0% [95% CI: 95.9%, 97.9%]) experienced at least 1 hypoglycemic event prospectively. The estimated rates of any and severe hypoglycemia were 26.6 (95% CI: 19.8, 35.0) and 14.1 (95% CI: 9.3, 20.4) events per patient-per year (PPY), respectively, for patients with T1DM and 18.3 (95% CI: 17.4, 19.2) and 12.1 (95% CI: 11.4, 12.9) events PPY, respectively, for patients with T2DM during the prospective period. At baseline, mean glycated hemoglobin (HbA1c) (±standard deviation) was 8.1 (±1.8%) for T1DM and 8.8 (±1.8%) for T2DM. Hypoglycemic rate was independent of HbA1c levels and types of insulin. Conclusions: This is the first patient dataset of self-reported hypoglycemia in Bangladesh; results confirm that hypoglycemia is underreported.

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