Ongoing burden and recent trends in severe hospitalised hypoglycaemia events in people with type 1 and type 2 diabetes in Scotland: A nationwide cohort study 2016-2022.

Aims: We examined severe hospitalised hypoglycaemia (SHH) rates in people with type 1 and type 2 diabetes in Scotland during 2016-2022, stratifying by sociodemographics.
Methods: Using the Scottish National diabetes register (SCI-Diabetes), we identified people with type 1 and type 2 diabetes alive anytime during 2016-2022. SHH events were determined through linkage to hospital admission and death registry data. We calculated annual SHH rates overall and by age, sex, and socioeconomic status. Summary estimates of time and stratum effects were obtained by fitting adjusted generalised additive models using R package mgcv.
Results: Rates for those under 20 with type 1 diabetes reached their minimum at the 2020-2021 transition, 30% below the study period average. A gradual decline over time also occurred among 20-49-year-olds with type 1 diabetes. Overall, females had 15% higher rates than males with type 2 diabetes (rate ratio 1.15, 95% CI 1.08-1.22). People in the most versus least deprived quintile experienced 2.58 times higher rates (95% CI 2.27-2.93) in type 1 diabetes and 2.33 times higher (95% CI 2.08-2.62) in type 2 diabetes.
Conclusions: Despite advances in care, SHH remains a significant problem in diabetes. Future efforts must address the large socioeconomic disparities in SHH risks.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: P.M.M. declares stock ownership in the following: Bayer and Roche Pharmaceuticals. H.M.C. declares grants from Juvenile Diabetes Research Foundation International, Diabetes UK, IQVIA, Chief Scientist Office, Medical Research Council (UK Research and Innovation), and European Union Commission, honoraria from Novo Nordisk, advisory board fees paid through her institution from Novo Nordisk and Bayer, and stock ownership in Bayer and Roche Pharmaceuticals. S.H. declares consulting fees paid through his institution from Vertex Pharma, Zucara Pharmaceuticals, and Zealand Pharma, honoraria from Medtronic and Novo Nordisk, and has served as Chair of DSMB for Eli Lilly development programme and as a Member of Novo Nordisk Independent Advisory Board. R.J.M. declares honoraria from Sanofi and Novo Nordisk for lectures and presentations, travel support from Sanofi, and is a non-executive member of NHS Tayside Health Board. F.W.G. declares advisory board fees from Abbott Diabetes and Insulet, speaker fees from Abbott Diabetes, Insulet, Novo Nordisk, and Lilly, and travel support from Abbott Diabetes and Novo Nordisk. S.P. declares grants from Novo Nordisk, Lilly, and Amgen, travel support from Novo Nordisk, and has participated on an Advisory board for Roche Pharmaceuticals. N.S. has consulted for and/or received speaker honoraria from Abbott Laboratories, Abbvie, Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Hanmi Pharmaceuticals, Janssen, Menarini-Ricerche, Novartis, Novo Nordisk, Pfizer, Roche Diagnostics, and Sanofi; and received grant support paid to his University from AstraZeneca, Boehringer Ingelheim, Novartis, and Roche Diagnostics outside the submitted work. No other potential conflicts of interest relevant to this article were reported.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)