Incidence of severe hypoglycemia and its association with serum adiponectin in Japanese patients with type 1 and insulin-treated type 2 diabetes: the Fukuoka Diabetes Registry.

AIMS: The incidence of severe hypoglycemia and its risk factors including an insulin-sensitizing adipokine, adiponectin were prospectively investigated in Japanese patients with type 1 or insulin-treated type 2 diabetes MATERIALS AND METHODS: 207 participants with type 1 diabetes (mean age, 55years) and 1,396 with insulin-treated type 2 diabetes (mean age, 65 years) from local diabetes registry were followed for 5 years (follow-up rate 99%). Severe hypoglycemia was defined as events requiring the assistance of others for recovery from hypoglycemia. RESULTS: The incidence of severe hypoglycemia was 9.2 per 100 person-year in those with type 1 diabetes and 2.3 per 100 person-year in those with insulin-treated type 2 diabetes, respectively. In type 1 diabetes, the risk was significant in those with history of severe hypoglycemia within a previous year, slow eating, and higher serum adiponectin (the highest vs. the lowest in quartile hazard ratio (HR) 2.36, 95%CI 1.22-4.69). In insulin-treated type 2 diabetes, the risk included age >/= 65 years, history of severe hypoglycemia within a previous year, alcohol consumption >/= 60 g/day, larger insulin dose, and higher serum adiponectin (the highest vs. the lowest in quartile, HR 2.95, 95%CI 1.22-4.69). In all participants, the incidence of severe hypoglycemia increased along with serum adiponectin (age-and sex-adjusted HR 1.65 per 1SD increase of log serum adiponectin, 95% CI 1.45-1.87). CONCLUSIONS: The incidence of severe hypoglycemia was prospectively determined and the association between severe hypoglycemia and higher serum adiponectin was observed in Japanese patients with type 1 and insulin-treated type 2 diabetes.