ABSTRACT Objective To assess national trends and inpatient outcomes among adults hospitalized with a primary diagnosis of hypoglycemia in the United States from 2017 to 2022. Methods We conducted a retrospective cross‐sectional analysis of the National Inpatient Sample. Adult hospitalizations aged 18 years or older with a principal ICD‐10‐CM diagnosis of hypoglycemia were included. The annual share of primary hypoglycemia hospitalizations was calculated per 100,000 adult NIS discharges. Outcomes included in‐hospital mortality, length of stay(LOS), and inflation‐adjusted hospital cost standardized to 2022 US dollars. Multivariable survey‐weighted logistic regression was used for mortality, a survey‐weighted generalized linear model (GLM) with a quasi‐Poisson distribution and log link was used for LOS, and a survey‐weighted GLM with a gamma distribution and log link was used for inflation‐adjusted hospital cost. Results The analysis included 330,910 weighted hypoglycemia hospitalizations. Mean age was 67 years; 52% were women; and 70% were Medicare‐insured. Diabetes mellitus (91%) was the most common comorbidity, while obesity (17%) was least common. Primary‐hypoglycemia discharges peaked in 2019 (195 per 100,000 adult NIS discharges), declined in 2021 (180), and increased again in 2022 (190). Mortality occurred in 1.6%, and median LOS was 3 days. Compared with 2017, adjusted mortality odds were higher in 2020 (OR 1.30, 95% CI 1.04–1.61), 2021 (OR 1.44, 95% CI 1.16–1.79), and 2022 (OR 1.33, 95% CI 1.07–1.65). Similarly, LOS and hospital costs were also higher in 2020, 2021, and 2022 compared to 2017. Congestive heart failure (CHF) and AF were associated with higher mortality odds, LOS, and cost. Conclusion Primary hypoglycemia hospitalizations declined during the pandemic years but became more severe and resource‐intensive over time. Patients with CHF or AF had higher mortality, higher LOS, and higher hospital costs, highlighting the need for integrated hypoglycemia surveillance and cardiometabolic care.
ABSTRACT Background Obesity is a major risk factor for cardiovascular disease, but traditional measures like BMI and waist circumference have limitations. New indices, BRI and ABSI, may better reflect fat distribution and cardiovascular risk. This study examined their association with carotid intima‐media thickness (cIMT) in young healthy adults. Methods In this cross‐sectional study within the Tehran Lipid and Glucose Study (TLGS) framework, 572 adults aged 20–40 years underwent anthropometric assessments, biochemical tests and carotid ultrasound for cIMT measurement. Anthropometric indices including BMI, WC, waist‐to‐height ratio (WHtR), ABSI and BRI were calculated. Associations between these indices and cIMT were analysed using correlation and multivariable linear regression models adjusting for demographic, metabolic and lifestyle factors. Receiver operating characteristic (ROC) curve analyses assessed the predictive ability of the indices for elevated cIMT. Result BRI and WHtR were nearly collinear ( r = 0.997) and showed modest positive correlations with cIMT in unadjusted analyses ( r = 0.103 for both), but these associations weakened after adjustment for cardiometabolic risk factors. WC was the only independent predictor of cIMT in partially adjusted models, though this significance disappeared in fully adjusted analyses. ABSI exhibited a significant but mechanistically unexpected inverse association with cIMT. ROC analyses indicated limited discriminative power for all anthropometric measures in predicting high cIMT, with BRI and WHtR having the highest but still modest area under the curve (AUC). Conclusion In young healthy adults, BRI and WHtR showed modest associations with subclinical carotid atherosclerosis, which weakened after adjustment. Waist circumference was an inconsistent predictor, and ABSI demonstrated an inverse relationship with cIMT. Further longitudinal studies are needed to confirm their clinical utility.
ABSTRACT Background Vitamin D deficiency and Type 2 diabetes (T2D) are highly prevalent in South Asian populations. Observational studies report inverse associations between serum 25‐hydroxyvitamin D [25(OH)D] and T2D risk, but these findings may reflect confounding or reverse causation. We used Mendelian randomization (MR) to assess the association between genetically predicted 25(OH)D and T2D risk in South Asians. Methods We conducted a two‐sample MR analysis using publicly available OpenGWAS summary statistics. One variant (rs3755967) met the conventional genome‐wide significance threshold ( p < 5 × 10 −8 ), while two additional variants (rs2459139 and rs72744878) met an exploratory threshold ( p < 1 × 10 −6 ). The three variants served as instruments for serum 25(OH)D in a South Asian GWAS (ukb‐e‐30890_CSA; n = 7380; mean F ‐statistic = 29.6; total R 2 = 1.06%). The primary outcome was BMI‐unadjusted T2D (ebi‐a‐GCST90093109; n = 50,533; 16,677 cases), with a BMI‐adjusted GWAS used for sensitivity analysis. The primary estimator was inverse‐variance weighted (IVW), supported by weighted‐median, MR‐Egger, simple‐mode, and weighted‐mode analyses. Heterogeneity and directional pleiotropy were assessed using Cochran's Q and the MR‐Egger intercept, respectively. Partial participant overlap could not be excluded because UK Biobank contributed to both datasets. Results The primary IVW analysis showed no statistically significant association between genetically predicted 25(OH)D and T2D risk ( β = 0.058, SE = 0.120, p = 0.630; OR = 1.06, 95% CI: 0.83–1.36). Weighted‐median and mode‐based estimates were also non‐significant. The MR‐Egger estimate was highly imprecise (OR = 32.0, 95% CI: 0.11–9103) because only three instruments were available. No significant heterogeneity or directional pleiotropy was detected, although these tests had limited power. The BMI‐adjusted sensitivity analysis produced similar findings. Conclusions We found no statistically significant evidence of a linear association between genetically predicted serum 25(OH)D and T2D risk. However, the small exposure GWAS, limited instrument set, exploratory instrument threshold, and possible sample overlap mean that small‐to‐moderate causal effects cannot be excluded. Larger South Asian GWAS are needed for more definitive inference.
ABSTRACT Introduction Continuous glucose monitoring (CGM) use may benefit people with diabetes and chronic kidney disease (CKD). In this propensity‐matched, retrospective analysis using Truveta‐provided de‐identified EMR data, changes in kidney function and glycemia were compared between cohorts starting real‐time CGM (RT‐CGM) use and CGM non‐users (No CGM). Methods Adults with type 1 or type 2 diabetes, treated with any insulin, with estimated glomerular filtration rate (eGFR) of 15–89 mL/min/1.73 m 2 were included. Changes in eGFR, albumin‐to‐creatinine ratio (ACR), and HbA1c between baseline and 3‐year follow‐up were assessed. Results RT‐CGM initiation ( N = 518 per cohort) was associated with a significantly slower decline in eGFR compared to No CGM. There was no significant difference in change in ACR between the groups ( N = 138 per cohort). RT‐CGM use ( N = 461 per cohort) was associated with a significantly greater decrease in HbA1c compared to No CGM. Conclusions These findings support RT‐CGM initiation among people with diabetes and CKD or at risk for CKD.
