Serum adiponectin tied to severe hypoglycaemia risk in diabetics

High serum adiponectin may be a risk factor for severe hypoglycaemia in patients with type 1 or insulin-treated type 2 diabetes, a new Japan study has found.

Researchers enrolled 207 patients (mean age, 55.0±14.9 years) with type 1 diabetes and 1,396 (mean age, 65.0±11.1 years) with insulin-treated type 2 diabetes. The study endpoint was severe hypoglycaemia, defined as an episode requiring the assistance from others to recover from. Latex immunonephelometry was used to measure serum adiponectin.

Multivariable Cox proportional hazards analysis found that high serum adiponectin was a significant risk factor for severe hypoglycaemia in type 1 diabetics (highest vs lowest quartile: hazard ratio [HR], 2.36, 95 percent confidence interval [CI], 1.22–4.69). A history of severe hypoglycaemia in the year prior was also significantly associated (HR, 2.04, 95 percent CI, 1.23–3.32).

In comparison, being a fast eater lowered the risk of severe hypoglycaemia events in this subpopulation (HR, 0.56, 95 percent CI, 0.31–0.98).

In participants with insulin-treated type 2 diabetes, high serum adiponectin again significantly increased the risk of developing severe hypoglycaemia (highest vs lowest quartile: HR, 2.95, 95 percent CI, 1.72; 5.23). Other risk factors were old age (≥65 years), a history of severe hypoglycaemia, high alcohol consumption and high doses of insulin.

“[W]e demonstrated the association between severe hypoglycaemia and higher serum adiponectin level, suggesting the importance of insulin sensitivity for insulin-induced severe hypoglycaemia,” said researchers.