Severe hypoglycemia symptoms, antecedent behaviors, immediate consequences and association with glycemia medication usage: Secondary analysis of the ACCORD clinical trial data

Denise E. Bonds, Michael E. Miller, Jim Dudl, Mark Feinglos, Faramarz Ismail-Beigi, Saul Malozowski, Elizabeth Seaquist, Debra L. Simmons, Ajay Sood

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background: Hypoglycemia is a common complication of diabetes treatment. This paper describes symptoms, predecessors, consequences and medications associated with the first episode of severe hypoglycemia among ACCORD participants with type 2 diabetes, and compares these between intensive (Int: goal A1C <6.0%) and standard (Std, goal A1C 7-7.9%) glycemia intervention groups.Methods: Information about symptoms, antecedents, and consequences was collected at the time participants reported an episode of severe hypoglycemia. Data on medications prescribed during the clinical trial was used to determine the association of particular diabetes drug classes and severe hypoglycemia.Results: The most frequently reported symptoms in both glycemia group were weakness/fatigue (Int 29%; Std 30%) and sweating (Int 26%; Std 27%), followed by confusion/disorientation (Int 22%; Std 29%) and shakiness (Int 21%; Std 19%). Approximately half of all events were preceded by a variation in food intake (Int 48%; Std 58%). The most common consequences were confusion (Int 37%; Std 34%), loss of consciousness (Int 25%; Std 25%), and hospitalization (Int 18%; Std 24%). The highest rates of hypoglycemia were found among those participants treated with insulin only (Int 6.09/100 person yrs; Std 2.64/100 person yrs) while the lowest were among those prescribed oral agents only (Int 1.93/100 person yrs; Std 0.20/100 person yrs).Conclusions: Severe hypoglycemia episodes were frequently preceded by a change in food intake, making many episodes potentially preventable. Symptoms of confusion/disorientation and loss of consciousness were frequently seen. The highest rates of hypoglycemia were seen with prescription of insulin, either alone or in combination with other medications.Clinical Trial Registration: Number: NCT00000620.

Original languageEnglish (US)
Article number5
JournalBMC Endocrine Disorders
Volume12
DOIs
StatePublished - May 30 2012
Externally publishedYes

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Hypoglycemia
Clinical Trials
Unconsciousness
Eating
Insulin
Sweating
Diabetes Complications
Type 2 Diabetes Mellitus
Fatigue
Prescriptions
Hospitalization
Pharmaceutical Preparations

Keywords

  • Hypoglycemia
  • Type 2 diabetes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Severe hypoglycemia symptoms, antecedent behaviors, immediate consequences and association with glycemia medication usage : Secondary analysis of the ACCORD clinical trial data. / Bonds, Denise E.; Miller, Michael E.; Dudl, Jim; Feinglos, Mark; Ismail-Beigi, Faramarz; Malozowski, Saul; Seaquist, Elizabeth; Simmons, Debra L.; Sood, Ajay.

In: BMC Endocrine Disorders, Vol. 12, 5, 30.05.2012.

Research output: Contribution to journalArticle

Bonds, Denise E. ; Miller, Michael E. ; Dudl, Jim ; Feinglos, Mark ; Ismail-Beigi, Faramarz ; Malozowski, Saul ; Seaquist, Elizabeth ; Simmons, Debra L. ; Sood, Ajay. / Severe hypoglycemia symptoms, antecedent behaviors, immediate consequences and association with glycemia medication usage : Secondary analysis of the ACCORD clinical trial data. In: BMC Endocrine Disorders. 2012 ; Vol. 12.
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