The Risk of Severe Hypoglycemia and Mortality in Patients with Type 2 Diabetes and Discharged with Acute Liver Injury
OBJECTIVE
To compare the risks of severe hypoglycemia and mortality between patients with type 2 diabetes (T2D) and discharged with and without acute liver injury.
RESEARCH DESIGN AND METHODS
From January 1, 2000, to December 31, 2010, we identified patients with T2D and hospitalization for acute liver injury and hospitalization for other causes from the National Health Insurance Research Database of Taiwan. Multivariable-adjusted Cox proportional hazards models were used to compare the risks of severe hypoglycemia and mortality between the study and control groups.
RESULTS
The incidence rates and adjusted hazard ratios (aHRs) for severe hypoglycemia within 90 days and 365 days after discharge were 12.28 and 5.59 per 1000 person-years [aHR 1.92 (1.30-2.85)] and 7.35 and 2.9 per 1000 person-years [aHR 1.98 (1.52-2.58)] for patients discharged with and without acute liver injury, respectively. The incidence rates and aHRs for mortality within 90 days and 365 days after discharge were 82.4 and 27.54 per 1000 person-years [aHR 1.73 (1.46-2.05)] and 36.8 and 9.3 per 1000 person-years [aHR1.94 (1.69-2.24)] for patients discharged with and without acute liver injury, respectively. The subgroup analysis of hypoglycemia risk in patients discharged with acute liver injury revealed no significant interaction in risk factors of age, chronic kidney disease, and medications, except for sex difference has significant interaction.
CONCLUSIONS
This cohort study demonstrated that patients with T2D and discharged with acute liver injury showed significantly higher risks of severe hypoglycemia and mortality within 90 days and 365 days after discharge than patients discharged with other causes.
Funding
This work was supported by grants from the Taipei Veterans General Hospital (V105C-204, V110C-175) and the Ministry of Science and Technology, R.O.C (MOST 110-2314-B-075-027-MY3), Taiwan. These funding agencies had no role in the study design, data collection and analysis, decision to publish, or manuscript preparation. No organization provided funds to assist with manuscript preparation, and data analysis was not performed by employees of funders or any author who received funding. The funders did not offer writing support. The corresponding authors had complete access to all data in the study and the final responsibility for the decision to publish.
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