Meta-analysis: Association between hypoglycaemia and serious adverse events in older patients

Mattishent, Katharina and Loke, Yoon Kong (2016) Meta-analysis: Association between hypoglycaemia and serious adverse events in older patients. Journal of Diabetes and its Complications, 30 (5). pp. 811-818. ISSN 1056-8727

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Abstract

Aims: We aimed to conduct a meta-analysis of serious adverse events (macro- and micro-vascular events, falls and fractures, death) associated with hypoglycaemia in older patients. Methods: We searched MEDLINE and EMBASE spanning a ten-year period up to March 2015 (with automated PubMed updates to October 2015). We selected observational studies reporting on hypoglycaemia and associated serious adverse events, and conducted a meta-analysis. We assessed study validity based on ascertainment of hypoglycaemia, adverse events and adjustment for confounders. Results: We included 17 studies involving 1.5 million participants. Meta-analysis of eight studies demonstrated that hypoglycemic episodes were associated with macrovascular complications, odds ratio (OR) 1.83 (95% Confidence Interval [CI] 1.64, 2.05), and microvascular complications in two studies OR 1.77 (95% CI 1.49, 2.10). Meta-analysis of four studies demonstrated an association between hypoglycaemia and falls or fractures, OR 1.89 (95% CI 1.54, 2.32) and 1.92 (95% CI 1.56, 2.38) respectively. Hypoglycaemia was associated with increased likelihood of death in a meta-analysis of eight studies, OR 2.04 (95% Confidence Interval 1.68, 2.47). Conclusion : Our meta-analysis raises major concerns about a range of serious adverse events associated with hypoglycaemia. Clinicians should prioritize individualized therapy and closer monitoring strategies to avoid hypoglycaemia in susceptible older patients.

Item Type: Article
Uncontrolled Keywords: hypoglycaemia,diabetes mellitus,falls,fractures,cardiovascular disease
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 01 Apr 2016 10:11
Last Modified: 17 Mar 2020 21:42
URI: https://ueaeprints.uea.ac.uk/id/eprint/58036
DOI: 10.1016/j.jdiacomp.2016.03.018

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