Non-linear associations of risk factors with mild hypoglycemia among Chinese patients with type 2 diabetes

Aims The present study aimed to examine the nonlinear associations between risk factors and mild hypoglycemia in Chinese patients with type 2 diabetes mellitus (T2DM). Methods From May 2013 to August 2013, we conducted a cross sectional survey of 6633 inpatients with T2DM and without severe hypoglycemia, aged 21–77years, from 81 top tertiary hospitals in China. Mild hypoglycemia was defined as having hypoglycemia with symptoms in one month. Binary logistic regression analysis with restricted cubic splines was used to estimate odds ratio curves of non-linear risk factors for mild hypoglycemia. Results Increasing body mass index was associated with decreasing risk of mild hypoglycemia in a linear manner while age, duration of diabetes, glycated hemoglobin (HbA1c), mean artery pressure and lipids were associated with mild hypoglycemia in non-linear manners. Age ≥40years, duration ≥2years, HbA1c ≥7.0–<11.5% (≥53–<102mmol/mol), triglyceride ≥1.7–<3.6mmol/L, low-density lipoprotein cholesterol (LDL-C) ≥2.6–<4.8mmol/L, and high-density lipoprotein cholesterol (HDL-C) ≥1.2–<4.8mmol/L were associated with increased risks of mild hypoglycemia. Conclusions Chinese T2DM patients with age≥40years, duration of diabetes ≥2–<6years, HbA1c ≥7.0–<11.5% (≥53–<102mmol/mol), LDL-C ≥2.6–<4.8mmol/L, HDL-C ≥1.2–<4.8mmol/L or triglyceride ≥1.7–<3.6mmol/L were at particularly high risk for mild hypoglycemia.