[Retrospective analysis of the incidence of severe hypoglycemia in 458 type 1 diabetic patients].

During 1 year a retrospective study concerning frequency and risk markers of severe hypoglycemia was conducted in type-1 diabetic patients undergoing their annual routine check-up. The aim was to contribute to the epidemiology of severe hypoglycemia and to investigate, whether severe hypoglycemia is associated with specific features of therapy (strategy of insulin treatment, level of metabolic control expressed as mean blood glucose and glycosilated hemoglobin, insulin species, use of betablocking agents) or with patient characteristics (age, duration of diabetes, awareness of hypoglycemic symptoms, late complications of diabetes). From the cohort of 710 eligible patients 458 agreed to participate in the study, 61% had experienced severe hypoglycemia at least once, 17% during the last year. The incidence calculated for the whole diabetes duration is 21/100 patient years, and for the last year 56/100 patient years. The following were risk markers for severe hypoglycemia: older age, longer duration of diabetes, reduced awareness of hypoglycemic symptoms, decreasing frequency of symptomatic hypoglycemic episodes, and lower HbA1c. No association was found with the following variables: Serum creatinine, autonomic neuropathy, use of betablocking agents, and presence of anti-insulin antibodies. Intensive insulin therapy with individualized treatment goals in terms of blood glucose control was successful in avoiding severe hypoglycemia in patients who had already experienced them before.