Korean J Fam Med.
2019 Jul;40(4):212-219. 10.4082/kjfm.18.0051.
Frequency and Severity of Hypoglycemia in Type 2 Diabetes Mellitus Patients Treated with a Sulfonylurea-Based Regimen at University-Affiliated Hospitals in Korea: The Naturalistic Evaluation of Hypoglycemic Events in Diabetic Subjects Study
- Affiliations
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- 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- 2Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
- 3Division of Cardiology, Department of Internal Medicine, Kyung Hee Medical Center, Kyung Hee University, Seoul, Korea.
- 4Division of Cardiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
- 5Department of Cardiology, Department of Internal Medicine, Bucheon Sejong Hospital, Bucheon, Korea.
- 6Department of Cardiology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
- 7Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea.
- 8Cardiovascular Institute, Yonsei University College of Medicine, Seoul, Korea.
- 9Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University School of Medicine and Hospital, Iksan, Korea.
- 10Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
- 11Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
- 12Department of Family Medicine, Konyang University Hospital, Daejeon, Korea.
- 13MSD Korea, Global Medical Affair, Seoul, Korea.
- 14Department of Cardiology, Korea University Guro Hospital, Seoul, Korea. parkcg@kumc.or.kr
- KMID: 2454757
- DOI: http://doi.org/10.4082/kjfm.18.0051
Abstract
- BACKGROUND
We assessed the frequency and severity of hypoglycemia in type 2 diabetes mellitus patients treated with sulfonylurea monotherapy or sulfonylurea+metformin.
METHODS
We conducted a retrospective, observational, cross-sectional study in 2011 and 2012 including patients with type 2 diabetes mellitus aged ≥30 years who were treated with ≥6 months of sulfonylurea monotherapy or sulfonylurea+metformin at 20 university-affiliated hospitals in Korea. At enrollment, glycated hemoglobin (HbA1c) was assessed; participants completed self-reported questionnaires describing hypoglycemia incidents over the past 6 months. A review of medical records up to 12 months before enrollment provided data on demographics, disease history, comorbidities, laboratory results, and drug usage.
RESULTS
Of 726 enrolled patients, 719 were included (55.6% male); 31.7% and 68.3% were on sulfonylurea monotherapy and sulfonylurea+metformin, respectively. Mean±standard deviation age was 65.9±10.0 years; mean HbA1c level was 7.0%±1.0%; 77.8% of patients had hypertension (89.4% used antihypertensive medication); 60.5% had lipid disorders (72.5% used lipid-lowering medication); and 52.0% had one or more micro- or macrovascular diseases. Among patients with A1c measurement (n=717), 56.4% achieved therapeutic goals (HbA1c <7.0%); 42.4% (305/719) experienced hypoglycemia within 6 months of enrollment; and 38.8%, 12.9%, 12.7%, and 3.9% of patients experienced mild, moderate, severe, and very severe hypoglycemia symptoms, respectively. Several reported hypoglycemia frequency as 1-2 times over the last 6 months. The mean number of very severe hypoglycemia episodes was 3.5±5.5.
CONCLUSION
Among type 2 diabetes mellitus patients treated with sulfonylurea-based regimens, glycemic levels were relatively well controlled but hypoglycemia remained a prevalent side effect.
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