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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".