medwireNews: Researchers have highlighted variation in the burden of hypoglycemia-related deaths worldwide, with the highest rates observed in Central and South America and the Caribbean.
The team, from the University of Leicester in the UK, say their findings “could help implement individual and public health measures to reduce national gaps and prevent growing trends in hypoglycemia-related deaths.”
The study is based on information from death certificates reporting hypoglycemia or diabetes as the underlying cause of death in the World Health Organization mortality database, and includes data for 109 countries primarily in Europe and the Americas. Only a small number of African and Asian countries were included.
Francesco Zaccardi and colleagues report in Diabetologia that, overall, the mean age-standardized proportion of hypoglycemia-related deaths was 4.49 per 1000 total diabetes deaths. The lowest proportion was recorded in Croatia and the highest in Kiribati, a sovereign state in the Pacific Ocean, at 0.11 and 283.1 per 1000 total diabetes deaths, respectively.
The majority of Central American, South American, and Caribbean countries, as well as Japan, reported higher than average proportions of hypoglycemia-related deaths, whereas most European countries, the USA, Canada, New Zealand, and Australia had lower than average proportions.
When the investigators looked at hypoglycemia-related death rates per population in 105 countries, they observed similar trends.
Overall, the age-standardised hypoglycemia-related death rate was 0.79 per 1 million person–years, and ranged from 0.01 in Croatia to 109.9 in Kiribati. However, Zaccardi et al point out that the age-standardized rates were lower than five per 1 million person–years in 89.5% of countries, meaning that absolute differences among countries were generally small.
The team also looked at trends in hypoglycemia-related deaths over time. Both the proportion and rate of hypoglycemia-related deaths increased by around 60% between 2000 and 2010, most notably in Argentina, Brazil, Chile, Japan, and the USA.
They then remained stable between 2010 and 2014, which the researchers put down to increasing awareness “of the potential harm of hypoglycaemia in individuals treated intensively, a greater attention towards hypoglycaemia, the recommendations of personalised targets by international guidelines and the availability of new drugs associated with a lower risk of hypoglycaemia in high-income countries.”
Zaccardi and co-authors conclude: “Further studies are required to unravel the contribution of clinical and socioeconomic factors, difference in diabetes prevalence and heterogeneity of death certification in determining lower rates and proportions of hypoglycaemia-related deaths in high-income countries in Europe, North America and Asia.”
By Laura Cowen
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