| アブストラクト | AIMS: Older individuals with diabetes are susceptible to harm as the result of hypoglycaemia; however, the consequences of hypoglycaemia in older individuals with dementia are not known. We aimed to test the association between hypoglycaemia and serious adverse events in older patients with diabetes and dementia, and whether the consequences of hypoglycaemia were affected by the presence of dementia. MATERIALS AND METHODS: This was a cohort study using the Clinical Practice Research Datalink in England (1997-2016). We selected participants, intervention (exposure) and follow-up to mirror two hypothetical target randomized controlled trials. The exposure of target trial 1 was hypoglycaemia in patients with dementia. Target trial 2 examined adverse effects of hypoglycaemia according to dementia status. We used Cox proportional hazard regression to estimate adjusted hazard ratios (aHR) for falls, fractures, cardiovascular events and mortality. RESULTS: In target trial 1, hypoglycaemia was associated with increased risk during a 12-month follow-up period for falls and fractures (aHR, 1.94 [95% CI, 1.67-2.24]), for cardiovascular events (aHR, 2.00 [95% CI, 1.61-2.48]) and for mortality (aHR, 2.36 [95% CI, 2.09-2.67]). In target trial 2, the presence of dementia was associated with increased risk of adverse events, following hypoglycaemia, during a 12-month follow-up period for falls and factures (aHR, 1.72 [95% CI, 1.51-1.96]) and for mortality (aHR, 1.27 [95% CI, 1.15-1.41]), but dementia had no effect on cardiovascular events (aHR, 1.14 [95% CI, 0.95 to 1.36]). CONCLUSIONS: Hypoglycaemia is associated with early increased risk of serious adverse events in older individuals with diabetes and dementia. |
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| ジャーナル名 | Diabetes, obesity & metabolism |
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| 投稿日 | 2019/5/10 |
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| 投稿者 | Mattishent, Katharina; Richardson, Kathryn; Dhatariya, Ketan; Savva, George M; Fox, Chris; Loke, Yoon K |
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| 組織名 | Norwich Medical School, University of East Anglia, Norwich, UK.;School of Health Sciences, University of East Anglia, Norwich, UK.;Department of Diabetes and Endocrinology, Norfolk and Norwich University Hospital;NHS Foundation Trust, Norwich, UK.;Quadram Institute Bioscience, Norwich Research Park, Norwich, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/31069922/ |
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