英国学者Eric S. Kilpatrick等对糖尿病控制和并发症试验（DCCT）数据进行分析后发现，对于1型糖尿病患者，无论接受强化降糖或常规降糖治疗，严重低血糖发作次数并不能预测其罹患糖尿病视网膜病变（DR）或糖尿病肾病（DN）的风险，而基线糖化血红蛋白（HbA1c）水平和研究期间平均HbA1c水平为独立预测因素。（Diabetic Med.2012年2月10日在线版）

在DCCT中，不论强化降糖治疗组还是常规降糖治疗组，研究期间平均HbA1c水平和基线HbA1c水平均可独立预测DR和DN。然而，低血糖发作次数对DR（强化降糖组OR=0.99，P=0.51；常规降糖组OR=0.94，P=0.05）或DN（强化降糖组OR=0.98，P=0.48；常规降糖组OR=1.03，P=0.17）并无预测价值。

原文：

Abstract

Aims:Severe hypoglycaemia may have a role in aggravating micro- and macrovascular disease in diabetes. Data from the Diabetes Control and Complication Trial have been reanalysed to ascertain whether the frequency of severe hypoglycaemia exerted an influence on the development and progression of retinopathy or nephropathy in people with Type 1 diabetes.

Methods:Using binary longitudinal multiple logistic regression, HbA1c at study baseline, mean HbA1c throughout the study and the number of severe hypoglycaemic episodes during the trial were compared to examine the risk of development/progression of retinopathy and nephropathy.

Results:Average HbA1c during the study and/or HbA1c at baseline were independently predictive of retinopathy and nephropathy both in the intensively and the conventionally treated patients (all P ≤0.001). However, the number of hypoglycaemic episodes did not add to HbA1c in predicting retinopathy [odds ratio (95% CI) 0.99 (0.96–1.01), P = 0.51 in intensively treated patients, 0.94 (0.89–1.00), P = 0.05, conventional] or nephropathy [odds ratio (95% CI) 0.98 (0.95–1.01), P = 0.48 intensive, 1.03 (0.98–1.10), P = 0.17 conventional].

Conclusions: The frequency of exposure to severe hypoglycaemia did not predict a different risk of developing retinopathy or nephropathy in either treatment group of the Diabetes Control and Complications Trial at any given HbA1c.