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Background <p>Adult T1DM has a large population base, is insulin dependent, and has a high hazard of hypoglycaemia risk. Therefore, the objective of this systematic review is to evaluate the risk factors linked to the occurrence of hypoglycemia in adult patients with type 1 diabetes mellitus. This analysis aims to aid in the formulation of preventive strategies and support early-stage intervention measures.</p> Methods <p>A computerised search of nine electronic databases, all with a timeframe of construction to December 2024, was conducted to find cross-sectional, cohort, and case-control studies on hypoglycaemia in patients with type 1 diabetes mellitus. The quality of the included studies was evaluated using the American Agency for Healthcare Research and Quality (AHRQ) or the Newcastle-Ottawa Scale (NOS). The combined odds ratio (OR) and the corresponding 95% confidence interval (CI) were calculated to evaluate the effect of the included risk factors on hypoglycaemia.</p> Results <p>A total of 31 studies including 54,634 participants were included. A total of 35 potentially relevant risk factors were identified. Ultimately, 18 risk factors were assessed for inclusion in the Meta-analysis, and 9 risk factors were statistically significant (<i>P</i> &lt; 0.05), including disease duration (OR = 1.07, 95% CI: 1.01–1.13), history of hypoglycaemia (OR = 2.31, 95% CI: 1.70–3.15),smoking (OR = 1.17, 95% CI: 1.07–1.28), diabetic nephropathy (OR = 0.83, 95% CI: 0.71–0.98), multiple daily insulin injections (OR = 1.96, 95% CI: 1.46–2.61 ), insulin dose (OR = 1.14, 95% CI: 1.08–1.21), hypoglycaemic unawareness (OR = 5.18, 95% CI: 1.81–14.84), impaired hypoglycaemic awareness (OR = 5.99, 95% CI: 4.62–7.75), diabetic neuropathy (OR = 2.05, 95% CI: 1.12–3.76).</p> Conclusion <p>This study identified 9 major risk factors affecting hypoglycaemia in adults with type 1 diabetes mellitus, including disease duration, history of hypoglycaemia, smoking, diabetic nephropathy (protective factor), multiple daily insulin injections, insulin dose, hypoglycaemic unawareness, impaired hypoglycaemic awareness and diabetic neuropathy.</p> Clinical trial number <p>Not applicable.</p>

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Risk factors for hypoglycaemia in adults with type 1 diabetes: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月25日

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  • Qiang Zhang,
  • Haojie Zhou,
  • Ruonan Lin,
  • Liping Hu,
  • Xiaoli Zhu

摘要

Background

Adult T1DM has a large population base, is insulin dependent, and has a high hazard of hypoglycaemia risk. Therefore, the objective of this systematic review is to evaluate the risk factors linked to the occurrence of hypoglycemia in adult patients with type 1 diabetes mellitus. This analysis aims to aid in the formulation of preventive strategies and support early-stage intervention measures.

Methods

A computerised search of nine electronic databases, all with a timeframe of construction to December 2024, was conducted to find cross-sectional, cohort, and case-control studies on hypoglycaemia in patients with type 1 diabetes mellitus. The quality of the included studies was evaluated using the American Agency for Healthcare Research and Quality (AHRQ) or the Newcastle-Ottawa Scale (NOS). The combined odds ratio (OR) and the corresponding 95% confidence interval (CI) were calculated to evaluate the effect of the included risk factors on hypoglycaemia.

Results

A total of 31 studies including 54,634 participants were included. A total of 35 potentially relevant risk factors were identified. Ultimately, 18 risk factors were assessed for inclusion in the Meta-analysis, and 9 risk factors were statistically significant (P < 0.05), including disease duration (OR = 1.07, 95% CI: 1.01–1.13), history of hypoglycaemia (OR = 2.31, 95% CI: 1.70–3.15),smoking (OR = 1.17, 95% CI: 1.07–1.28), diabetic nephropathy (OR = 0.83, 95% CI: 0.71–0.98), multiple daily insulin injections (OR = 1.96, 95% CI: 1.46–2.61 ), insulin dose (OR = 1.14, 95% CI: 1.08–1.21), hypoglycaemic unawareness (OR = 5.18, 95% CI: 1.81–14.84), impaired hypoglycaemic awareness (OR = 5.99, 95% CI: 4.62–7.75), diabetic neuropathy (OR = 2.05, 95% CI: 1.12–3.76).

Conclusion

This study identified 9 major risk factors affecting hypoglycaemia in adults with type 1 diabetes mellitus, including disease duration, history of hypoglycaemia, smoking, diabetic nephropathy (protective factor), multiple daily insulin injections, insulin dose, hypoglycaemic unawareness, impaired hypoglycaemic awareness and diabetic neuropathy.

Clinical trial number

Not applicable.