Severe hypoglycemia symptoms, antecedent behaviors, immediate consequences and association with glycemia medication usage: Secondary analysis of the ACCORD clinical trial data

Table 4 Adjusted hazard ratio (HR) of severe hypoglycemia by combination of classes ⁽¹⁾

Medication Use in Interval Antecedent to Ascertainment of Event Status	Intensive			Standard
	HR	95% CI	P value	HR	95% CI	P value
Just Oral Agents vs. Just Insulin	0.53	(0.36, 0.78)	<.0001	0.13	(0.08, 0.24)	<.0001
Oral Agents plus Insulin vs. Just Insulin	0.93	(0.67, 1.31)	0.69	0.97	(0.66, 1.43)	0.89
No Glycemia Medication⁽²⁾ vs. Just Insulin	1.47	(0.35, 6.1)	0.60	0.15	(0.02, 1.09)	0.06
Insulin plus Sensitizer vs. Just Insulin⁽³⁾	1.19	(0.88, 1.61)	0.25	0.98	(0.69, 1.40)	0.93
No Insulin or Sensitizer⁽⁴⁾ vs. Just Insulin⁽³⁾	1.32	(0.56, 3.11)	0.52	0.22	(0.08, 0.62)	<.0001
Just Sensitizer vs. Just Insulin⁽³⁾	0.66	(0.45, 0.94)	0.02	0.14	(0.07, 0.25)	<.0001
Metformin + Sulfonlyurea + TZD vs. Metformin + TZD⁽⁵⁾	0.94	(0.72, 1.23)	0.65	0.60	(0.32, 1.11)	0.10
2 meds vs. 0 or 1 meds	0.83	(0.46, 1.5)	0.53	1.08	(0.64, 1.82)	0.78
3 meds vs. 0 or 1 meds	1.04	(0.59, 1.82)	0.89	1.82	(1.10, 3.00)	0.02

⁽¹⁾ All results control for the following baseline covariates: age, gender, race, education, time since diabetes diagnosis, history of neuropathy/nerve problems, BMI, A1C, albumin to creatinine ratio, serum creatinine, LDL-C, and factors used to stratify randomization (treatment groups within the BP and Lipid trials and the presence of clinical cardiovascular disease)
⁽²⁾ In the standard group, there were 430 person years out of a total of 17,698 person years (2.4% of all follow-up) and in the intensive group, 35 person years out of a total of 17,130 person years (0.2%) in which participants were on no glycemia medications.
⁽³⁾ Model also controls for use of AGI’s, meglitinide, incretins and sulfonylurea.
⁽⁴⁾ Participants in this group were prescribed sulfonylureas, AGI, meglitinide, incretin or exenatide.
⁽⁵⁾ Model also controls for use of Insulin, AGI’s, meglitinide, incretins and sulfonylurea.

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