{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T16:26:08Z","timestamp":1782231968066,"version":"3.54.5"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T00:00:00Z","timestamp":1649635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Several risk factors for severe hypoglycaemia (SH) are associated with insulin\u2010treated diabetes. This study explored potential risk factors in adults with insulin\u2010treated type 2 diabetes mellitus (T2DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>In this case\u2010control study, adults with T2DM initiating insulin were identified in the IQVIA PharMetrics\u00ae Plus database. The index date was the date of the first SH event (cases). Using incidence\u2010density sampling, controls were selected from those who had been exposed \u2018at risk\u2019 of SH for the same amount of time as each case. After exact\u2010matching on the well\u2010established factors, previously unreported risk factors were evaluated through conditional logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 3153 case\u2010control pairs, pregnancy [odds ratios (OR)\u00a0=\u00a03.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0003], alcohol abuse (OR\u00a0=\u00a02.43,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u00a0.0001), short\u2010\/rapid\u2010acting insulin (OR\u00a0=\u00a02.22\/1.47,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001), cancer (OR\u00a0=\u00a01.87,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001), dementia\/Alzheimer\u2032s disease (OR\u00a0=\u00a01.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0175), peripheral vascular disease (OR\u00a0=\u00a01.59,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001), antipsychotics (OR\u00a0=\u00a01.59;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0059), anxiolytics (OR\u00a0=\u00a01.51,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0012), paralysis\/hemiplegia\/paraplegia (OR\u00a0=\u00a01.51,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0416), hepatitis (OR\u00a0=\u00a01.50,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0303), congestive heart failure (OR\u00a0=\u00a01.47,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0002), adrenergic\u2010corticosteroid combinations (OR\u00a0=\u00a01.45,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0165), \u03b2\u2010adrenoceptor agonists (OR\u00a0=\u00a01.40,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0225), opioids (OR\u00a0=\u00a01.38,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001), corticosteroids (OR\u00a0=\u00a01.35,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0159), cardiac arrhythmia (OR\u00a0=\u00a01.29.\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0065), smoking (OR\u00a0=\u00a01.28,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.005), Charlson Comorbidity Index score 2 (OR\u00a0=\u00a01.28,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0026), 3 (OR\u00a0=\u00a01.41,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0016) or \u22654 (OR\u00a0=\u00a01.57,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0002), liver\/gallbladder\/pancreatic disease (OR\u00a0=\u00a01.26,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0182) and hypertension (OR\u00a0=\u00a01.19,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.0164) were independently associated with SH.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although all people with insulin\u2010treated diabetes are at risk of SH, these results have identified some previously unrecognized risk factors and sub\u2010groups of insulin\u2010treated adults with T2DM at greater risk. Scrutiny of current therapies and comorbidities are advised as well as additional glucose monitoring and education, when identifying and managing SH in vulnerable populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.14690","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T01:19:43Z","timestamp":1646875183000},"page":"1235-1244","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Previously unrecognized risk factors for severe hypoglycaemia requiring emergency medical care in insulin\u2010treated type 2 diabetes: Results from a real\u2010world nested case\u2010control study"],"prefix":"10.1111","volume":"24","author":[{"given":"Julie","family":"Settles","sequence":"first","affiliation":[{"name":"Eli Lilly and Company Corporate Center  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Kan","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company Corporate Center  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Child","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company Corporate Center  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6806-3188","authenticated-orcid":false,"given":"Magdaliz","family":"Gorritz","sequence":"additional","affiliation":[{"name":"IQVIA Real\u2010World Evidence Solutions Plymouth Meeting  Plymouth Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasjit K.","family":"Multani","sequence":"additional","affiliation":[{"name":"IQVIA Real\u2010World Evidence Solutions Plymouth Meeting  Plymouth Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine B.","family":"McGuiness","sequence":"additional","affiliation":[{"name":"IQVIA Real\u2010World Evidence Solutions Plymouth Meeting  Plymouth Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolin L.","family":"Wade","sequence":"additional","affiliation":[{"name":"IQVIA Real\u2010World Evidence Solutions Plymouth Meeting  Plymouth Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian M.","family":"Frier","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Science, The Queen's Medical Research Institute University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-S009"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2014.170"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-0279"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-018-1018-0"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-S006"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-1669"},{"issue":"3","key":"e_1_2_9_8_1","first-page":"186","article-title":"Assessment of the impact of fear of hypoglycemic episodes on glycemic and hypoglycemia management","volume":"29","author":"Leiter LA","year":"2005","journal-title":"Can J Diabetes"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2006.02.004"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.12.2948"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.3844"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-007-0599-y"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1562"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S169835"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2009.10.013"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-0819"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.2275"},{"key":"e_1_2_9_18_1","unstructured":"IQVIA. 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