Hemoglobin A1c proportion, mortality rate, and risk factors for death in diabetic patients with severe hypoglycemia: A multicenter retrospective survey over ten years

ObjectiveTo investigate the HbA1c proportion and mortality rate across diabetic patients with severe hypoglycemia and the risk factors for death.MethodsAll the diabetic patients with severe hypoglycemia were divided into HbA1c < 6.5% group and HbA1c ≥ 6.5% group. The proportion of HbA1c, mortality rate and the risk factors for death were analyzed. Common causes for severe hypoglycemia were also analyzed.ResultsThe percentages of HbA1c in the HbA1c < 6.5% and HbA1c ≥ 6.5% groups were 51.2% and 48.8%, respectively. The mortality rates were not significantly different between the 2 groups (5.3% vs. 5.1%, χ2 = 0.01, p = 0.17). Binary logistic regression analysis revealed that in both groups, creatinine, aspartate aminotransferase, and uric acid levels were the risk factors for death. In the HbA1c < 6.5% and HbA1c ≥ 6.5% groups, 65.0% and 64.2% showed common causes of severe hypoglycemia, respectively.ConclusionsWith respect to severe hypoglycemia, equal attention should be paid to patients with an HbA1c level of ≥6.5% and those with an HbA1c level of <6.5%. The mortality rate is approximately 5% in severe hypoglycemia no matter how the HbA1c level is. Creatinine, aspartate aminotransferase, and uric acid are the main risk factors in both groups. Two-thirds of severe hypoglycemia cases could be prevented.