Diab Obes Metab: Kidney function reduces risk of low blood sugar death in diabetics

Diabetes and chronic kidney disease share common risk factors, and about 25% of people with diabetes also have chronic kidney diseasewhether decreased renal function increases the risk and severity of hypoglycemia in diabetic patients, there is no good researchOur goal is to assess the possible association between estimated glomerular filtration rates (eGFR) and low blood sugar in adult styronet diabetesobservational study of adult diabetics from the Stockholm Creatinine Measurement (SCREAM) project, a Swedish healthcare use queue, was conducted between 2007 and 2011We assessed the incidence ratio (IRR) of hypoglycemia (overall and severance) of outpatient diagnosis and outpatient blood glucose testing using the zero-expansion negative binomial regression method," which was assessed by eGFR stratificationWe identified clinical prediction factors using the ordinal logistic regression and used the Cox Scale Risk Model to assess the relationship between 7-day and 30-day mortality rates of low blood sugar and eGFRThe Stockholm Creatinine Study (SCREAM) included 29,434 diabetics in 2007-2011, 13 percent of whom were type 1 diabetes, with an average age of 66 years, 43 percent of women, and a median eGFR of 80/ml/1.73m2, in the Stockholm Study of Creatinine (SCREAM) through a restrictive spline regression model1,812 (6.2%) had at least one record of hypoglycemia during a two-year follow-upThe risk of hypoglycemia increases linearly with the decrease of eGFR, with eGFR 60-89 having an IRR of 1.2 (95% 1.0-1.4) and an EGFR 15 mL/min/1.73 m2IRR of 5.8 (3.8-9.9.9.9.9) compared to eGFR 90-104 mL/min/1.73 m2This trend can be observed in mild and severe hypoglycemiaCompared to eGFR 90-104 mL/min/1.73 m
2 , the mortality rate increased for 7 days and 30 days after hypoglycemia with the reduction of eGFR, which peaked at 15 mL/min/1.73 m 2 (risk ratio 21.2,95% CI 5.1-87.9) Lower eGFR categories, type 1 diabetes, previous hypoglycemia, liver disease, diabetes complications, and the use of insulin and sulfonyl drugs increased the risk of hypoglycemia in this large-scale observational study, low eGFR is closely related to the occurrence, severity and mortality of hypoglycemia in diabetic patients
Dr Lee, an academic at Mace, said the main features of the study were: "
1 study is better entry point." The associated eGFR-related deaths of hypoglycemia have been associated with a lessconcerned perspective in the past Previous studies have found that the risk of death in patients with CKD is increased when they are associated with diabetes, but the risk of death from diabetes includes multiple factors 2 This study is a large real-world study, on the one hand, large sample size, on the other hand, a long time span, so the researchers used a variety of statistical strategies, including limiting the spline regression model, to analyze eGFR and different low blood sugar caused by the risk of death between the curve, which is worth learning and learning In addition, the study used some interesting statistical strategies of zero-inflated negative binomial regression and ordinal logistic regression to reduce bias in the study, which is also worth learning from