ArticleThe Korean journal of internal medicine2026
Diabetes progression and severe hypoglycemia: a nationwide cohort study of 2,475,605 adults with type 2 diabetes mellitus.
Article in The Korean journal of internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
aimsSevere hypoglycemia (SH) is a major concern in type 2 diabetes mellitus (T2DM). We evaluated whether a composite diabetes progression score could predict incident SH.
methodsUsing the Korean National Health Insurance Service database, we identified 2,475,605 adults with T2DM who underwent health examinations in 2015-2016. Incident SH was defined by ICD-10 codes plus emergency department visit or hospitalization. The progression score (range, 0-6) comprised six indicators: longer diabetes duration, use of ≥ 3 oral glucose-lowering drug classes, insulin use, chronic kidney disease (CKD), cardiovascular disease, and diabetic retinopathy.
resultsDuring 1 year of follow-up, 1,186 SH events occurred. Each component of diabetes progression was independently insuassociated with SH risk hazard ratios (HRs) from 1.19-3.27, with insulin use and CKD showing the largest effects. SH risk increased stepwise with higher progression scores. Compared with a score of 0, the adjusted HRs (95% confidence intervals) were 3.35 (2.63-4.27), 7.74 (6.15-9.74), 12.61 (9.97-15.95), 22.39 (17.44-28.75) for scores 1, 2, 3, and ≥ 4, respectively.
conclusionA concise diabetes progression score strongly stratified short-term SH risk in this nationwide cohort, and may help target proactive prevention and early intervention.
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