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Why Holstein et al. (1) report in their current study considerably lower incidences of severe hypoglycemic events in patients with type 1 and type 2 diabetes is not clear. The authors purport that their study is population based. There is, however, substantial doubt that ascertainment of diabetic patients with severe hypoglycemia was really complete in the region under investigation with 200,000 inhabitants in North-Rhine Westphalia, Germany. In the article, incidence of severe hypoglycemia in patients with type 1 diabetes was 11.5 in the first period and 23.4 episodes/100,000 person-years in the second period. In patients with type 2 diabetes 18.5 and 32.6 episodes/100,000 person-years were observed in …

diabetes care

Comment on: Holstein et al. Substantial Increase in Incidence of Severe Hypoglycemia Between 1997–2000 and 2007–2010: A German Longitudinal Population-Based Study. Diabetes Care 2012;35:972–975