Associations of Colonoscopy and Risk of Hypoglycemia in Patients with Type 2 Diabetes

Figures & data

Figure 1 Study flow diagram.

Notes: Severe hepatic impairment (alanine aminotransferase, or aspartate aminotransferase; total bilirubin levels > 3.0 times over the upper limit of normal); severe renal impairment (estimated glomerular filtration rate < 30 mL/min/1.73 m²).

Table 1 Baseline Characteristics of the Patients Included in the Study (n = 1016)

Variable	Hypoglycemia Group (n=117)	Non-Hypoglycemia Group (n=899)	p value
Gender, n (%)			NS
Female	56 (47.9)	357 (39.7)
Male	61 (52.1)	542 (60.3)
Age (years), mean ± SD	58.08 ± 13.84	57.29 ± 13.56	NS
Length of hospital stay (days), mean ± SD	11.46 ± 4.54	9.75 ± 4.12	<0.001
Duration of diabetes (years), mean ± SD	12.60 ± 9.10	10.03 ± 7.86	0.001
BMI (kg/m^2), mean ± SD	24.32 ± 3.68	24.64 ± 3.42	NS
Diabetic complications, n (%)
Diabetic retinopathy	48 (41.0)	260 (28.9)	0.008
Diabetic peripheral neuropathy	86 (73.5)	542 (60.3)	0.006
Diabetic peripheral vascular disease	88 (75.2)	638 (71.0)	NS
Diabetic nephropathy	25 (21.4)	113 (14.79)	0.010
Diabetic foot	4 (3.4)	12 (1.3)	NS
Comorbidities, n (%)
Hypertension	51 (43.6)	394 (43.8)	NS
Cerebrovascular disease	16 (13.6)	165 (18.4)	NS
Hyperlipidemia	55 (47.0)	374 (41.6)	NS
Coronary heart disease	12 (10.3)	107 (11.9)	NS
Antidiabetic drugs, n (%)
Insulin	86 (73.5)	526 (58.5)	0.002
Total insulin dose (U), mean ± SD	25 (0, 37)	20 (0, 30)	<0.001
Metformin	44 (37.6)	420 (46.7)	NS
Sulfonylureas	9 (7.6)	126 (14.0)	NS
α-Glucosidase inhibitors	12 (10.3)	73 (8.1)	NS
Thiazolidinediones	1 (0.8)	13 (1.4)	NS
DDP-4 inhibitors	46 (39.3)	391 (43.5)	NS
SGLT2	38 (32.5)	371 (41.3)	NS
Laboratory data
HbA1c (%)	9.13 ± 2.60	9.00 ± 2.38	NS
Fasting plasma glucose (mmol/L)	7.76 ± 4.00	8.70 ± 3.38	0.006
2-hour plasma glucose (mmol/L)	11.50 ± 5.09	13.03 ± 4.76	0.001
Fasting C-peptide (mmol/L)	1.74 ± 1.12	1.81 ± 1.13	<0.001
2-hour C-peptide (mmol/L)	3.23 ± 3.12	4.53 ± 3.17	<0.001
Triglyceride (mmol/L), M (P25, P75)	1.44 (0.94, 2.04)	1.47 (1.03, 2.32)	NS
Total cholesterol (mmol/L), M (P25, P75)	4.37 (3.68, 5.26)	4.41 (3.63, 5.22)	NS
HDL-C (mmol/L)	1.12 ± 0.31	1.06 ± 0.71	NS
LDL-C (mmol/L)	2.78 ± 1.07	2.69 ± 1.00	NS
eGFR (mL/min/1.73 m^2)	82.99 ± 26.46	89.28 ± 24.57	0.006
Blood urea nitrogen (mmol/L), M (P25, P75)	5.52 (4.52,7.10)	5.42 (4.31,6.59)	NS
Serum creatinine (umol/L), M (P25, P75)	76 (62, 94)	72 (60, 88)	NS
Colonoscopy, n (%)	37 (31.6%)	191 (21.3%)	0.012

Notes: Continuous variables were presented by mean ± SD, or by median (interquartile range) in the case of a skewed distribution. Categorical variables were expressed as proportions. The group without the occurrence of hypoglycemia is termed as non-hypoglycemia group.

Abbreviations: NS, non-Significant; BMI, body mass index; DDP-4, dipeptidyl peptidase-4; SGLT2, Sodium-glucose cotransporter protein 2; HbA1c, Glycated hemoglobin; HDL-C, high-density lipoprotein-cholesterol; LDL-C, low-density lipoprotein-cholesterol; eGFR, estimated glomerular filtration rate.

Table 2 Analyzing the Association of Colonoscopy and Hypoglycemia Using Logistic Regression Analysis (n = 1016)

	With Colonoscopy	Without Colonoscopy	AOR (95% CI)
			Model 1	Model 2	Model 3
Hypoglycemia No. (%)	37 (16.2%)	80 (10.1%)	1.75 (1.15–2.67)	1.81 (1.17–2.80)	1.99 (1.25–3.19)

Notes: Model 1 was adjusted for age and gender; Model 2 was adjusted for the length of hospital stay, disease duration, diabetic retinopathy, diabetic peripheral neuropathy, and diabetic nephropathy based on Model 1; Model 3 was adjusted for FBG, 2h PG, FCP, 2h CP, e-GFR, and insulin based on Model 2.

Abbreviations: AOR, adjusted odds ratio; CI, confidence interval.

Figure 2 Subgroup analysis of the relationship between colonoscopy and hypoglycemia.

Abbreviations: HbA_1c, glycated hemoglobin; BMI, body mass index; AOR, adjusted odds ratio; CI, confidence interval.