Association of Severe Hypoglycemia Trajectory with Risk of Cardiovascular Events in People Living with Type 1 Diabetes Mellitus: A Population Based Cohort Study

Abstract

Severe hypoglycemia is one of the major complications of Type 1 Diabetes Mellitus (T1DM) but little information has been available concerning frequency or trajectory of severe hypoglycemia events with T1DM This study used Group-Based Trajectory Modeling technique to simultaneously consider timing and frequency of severe hypoglycemia events which was used to associate with cardiovascular disease (CVD) risk and all-cause mortality Data were retrieved from National Health Insurance Research Database Patients with a diagnosis of T1DM between 1998 and 2003 were selected as the study subjects The 4-year period following date of the first T1DM diagnosis was used to determine types of trajectory All study subjects were then followed to December 31 2013 Early high risk group (GROUP1) late high risk group (GROUP2) and moderate risk group (GROUP3) were identified Patients who didn’t experience any severe hypoglycemia were defined as the CONTROL GROUP Cox regression model showed that compared to CONTROL GROUP GROUP1 was associated with an elevated adjusted hazard ratio (aHR) at 1 138 (P=0 608) However GROUP2 and GROUP3 were associated with reduced CVD risk (aHR=0 153 P=0 061; aHR=0 772 P=0 191 respectively) Additionally compared to CONTROL GROUP GROUP1 and GROUP3 had higher risk of all-cause mortality with aHR of 1 298 (P=0 272) and 1 038 (P=0 823) while GROUP2 was associated with a lower risk of all-cause mortality (aHR=0 412 P=0 126) We concluded compared with the CONTROL GROUP the three types of trajectory were all not significantly associated with CVD risk or all-cause-mortality

Date of Award	2019
Original language	English
Supervisor	Chung-Yi Li (Supervisor)