High and low HbA1c linked to hypoglycaemia

The US study in 9000 type 2 diabetes patients from a healthcare system database showed that severe hypoglycaemia, defined as passing out or needing help to manage it, occurred in 9.3% to 13.8% of patients across HbA1c categories from less than 6% to 9% or greater.

Compared with HbA1c of 7% to 7.9%, people with HbA1c of less than 6% had a 25% increased relative risk of severe hypoglycaemia, and those with HbA1c of 9% or more had a 16% increased risk.

The U-shaped relationship between HbA1c and severe hypoglycaemia was not altered by the category of diabetes medication patients were receiving, their age or duration of diabetes, though hypoglycaemia was most common amongst those using insulin therapy.

Professor Anushka Patel, chief scientist at the George Institute for Global Health, said the study was a reminder that people with high