Evidence mapPaperPMID 40919666Full record

ArticleDiabetes, obesity & metabolism2025

Declining incidence of hypoglycaemia in diabetes secondary to chronic pancreatitis: A nationwide cohort study from 2003 to 2022.

Line Davidsen, Morten H Jensen, Asbjørn M Drewes, Filip K Knop, Frederico G S Toledo, Søren S Olesen

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Article in Diabetes, obesity & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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5 · Who and what money

Authors and funding

6 authors.

Line DavidsenCentre for Pancreatic Diseases and Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.ORCID https://orcid.org/0000-0002-1120-8144
Morten H JensenDepartment of Health Science and Technology, Aalborg University, Aalborg, Denmark.ORCID https://orcid.org/0000-0002-6649-8644
Asbjørn M DrewesCentre for Pancreatic Diseases and Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.
Filip K KnopCenter for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Frederico G S ToledoDivision of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Søren S OlesenCentre for Pancreatic Diseases and Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsPopulation-based studies have consistently shown that individuals with diabetes secondary to chronic pancreatitis (pancreatic diabetes) have a high risk of hypoglycaemia. We aimed to investigate whether this risk has declined over recent years following the introduction of modern glucose-lowering medications. MATERIALS AND

methodsIn this Danish nationwide population-based cohort study, we included all adults with new-onset diabetes between 1998 and 2022 and classified them as having pancreatic diabetes, type 1, or type 2 diabetes. We examined annual incidence rates of hypoglycaemia leading to hospitalisation, trends in dispensed glucose-lowering medications, and associations with hypoglycaemia risk.

resultsAmong 583 220 individuals with new-onset diabetes, 3383 (0.6%) were classified as pancreatic diabetes, 12 383 (2.1%) as type 1 diabetes, and 567 454 (97.3%) as type 2 diabetes. Comparing 2003-2006 to 2019-2022, the incidence of severe hypoglycaemia declined within each diabetes subtype: by 69% in pancreatic diabetes (incidence rate ratio (IRR) 0.33, 95% CI 0.25-0.40), 57% in type 1 diabetes (IRR 0.43, 95% CI 0.38-0.49), and 65% in type 2 diabetes (IRR 0.35, 95% CI 0.33-0.37). This coincided with a shift from human to analogue insulin and an increase in the use of metformin in individuals with pancreatic diabetes. Metformin use was associated with a lower risk of severe hypoglycaemia (adjusted hazard ratio 0.36, 95% CI 0.26-0.48). All types of insulin were associated with higher hypoglycaemia risk; insulin analogues carried a lower risk than human insulin.

conclusionHospitalisation for hypoglycaemia in pancreatic diabetes has declined substantially over time, alongside notable changes in treatment patterns.

Indexed as

Diabetes Mellitus, Type 1Diabetes Mellitus, Type 2HypoglycemiaPancreatitis, ChronicAdultAgedCohort StudiesDenmarkFemaleHospitalizationHumansHypoglycemic AgentsIncidenceMaleMiddle AgedHypoglycemic Agentschronic pancreatitisglucose‐lowering medicationshypoglycaemiasecondary diabetestime trends

Identifiers

PMID40919666
PMCPMC12587242

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.