Observational studyDiabetologia2020
Severe hypoglycaemia and absolute risk of cause-specific mortality in individuals with type 2 diabetes: a UK primary care observational study.
Observational study in Diabetologia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Association of hypoglycaemia with the risks of arrhythmia and mortality in individuals with diabetes - a systematic review and meta-analysis.Frontiers in endocrinology · 2023Pooled it
- Type 2 diabetes mellitus.Nature reviews. Disease primers · 2026Review
- Predictive value of three insulin resistance surrogate indices for symptomatic hypoglycemia risk in hospitalized patients with type 2 diabetes: a retrospective cohort study.BMC endocrine disorders · 2026Article
- Clinical perspectives of new insights and tools to minimize the hypoglycaemia burden connected with type 2 diabetes pharmacotherapy.Cardiovascular diabetology · 2025Article
- Obesity and its management in primary care setting.Journal of diabetes and its complications · 2025Review
- Review
- Inflammatory markers link triglyceride-glucose index and obesity indicators with adverse cardiovascular events in patients with hypertension: insights from three cohorts.Cardiovascular diabetology · 2025Article
- The association between acute kidney injury and dysglycaemia in critically ill patients with and without diabetes mellitus: a retrospective single-center study.Renal failure · 2024Article
- Estimating risk of consequences following hypoglycaemia exposure using the Hypo-RESOLVE cohort: a secondary analysis of pooled data from insulin clinical trials.Diabetologia · 2024Article
- Fasting blood glucose and the risk of all-cause mortality in patients with diabetes mellitus undergoing hemodialysis.Kidney research and clinical practice · 2024Article
- Clinical perspectives on the frequency of hypoglycemia in treat-to-target randomized controlled trials comparing basal insulin analogs in type 2 diabetes: a narrative review.BMJ open diabetes research & care · 2024Review
- Terminal trajectory of HbAFrontiers in endocrinology · 2024Article
- Triglyceride glucose index as a predictor of mortality in middle-aged and elderly patients with type 2 diabetes in the US.Scientific reports · 2023Article
- Acute kidney injury: a strong risk factor for hypoglycaemia in hospitalized patients with type 2 diabetes.Acta diabetologica · 2023Article
- Article
- Relative protein intake and associations with markers of physical function in those with type 2 diabetes.Diabetic medicine : a journal of the British Diabetic Association · 2022Article
- Sulfonylureas in the Current Practice of Type 2 Diabetes Management: Are They All the Same? Consensus from the Gulf Cooperation Council (GCC) Countries Advisory Board on Sulfonylureas.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2021Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
aims/hypothesisSeveral pathophysiological mechanisms would suggest a causal link between hypoglycaemia and cardiovascular death; conversely, current knowledge would not support a causal relationship with other causes of death. To clarify the nature and the magnitude of the association between hypoglycaemia and death, we investigated the 5 year mortality risks for cardiovascular disease, cancer and other causes in individuals with type 2 diabetes admitted to hospital for a severe hypoglycaemic episode.
methodsWe defined in the UK Clinical Practice Research Datalink database a prevalent cohort of adults with type 2 diabetes diagnosed between 1 January 1998 and 1 January 2011 (index date), with available linkage to the Office for National Statistics (ONS) and the Hospital Episode Statistics (HES). A hospital admission reporting hypoglycaemia as the underlying cause was identified before the index date in the HES; date and underlying cause of death were obtained from the ONS. We quantified the 5 year risk of cause-specific death in people with and without admission to hospital for severe hypoglycaemia, adjusting for potential confounders and accounting for competing risk.
resultsOf the 74,610 subjects included in the cohort, 388 (0.5%) were admitted at least once for a severe hypoglycaemic episode; subjects admitted were older, with higher HbA CONCLUSIONS/
interpretationThe results of this study indicate severe hypoglycaemia as a marker of, rather than causally linked to, an increased risk of long-term mortality. Regardless of the nature of the association, a severe hypoglycaemic episode represents a strong negative prognostic factor in patients with type 2 diabetes. Graphical abstract.
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Registered trials
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