Risk factors for hypoglycaemia in adults with type 1 diabetes: a systematic review and meta-analysis
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.030 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.017 | 0.033 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".