Diabetes Res Clin Pract. 2026 Apr 3:113241. doi: 10.1016/j.diabres.2026.113241. Online ahead of print.
ABSTRACT
AIMS: The prevalence of diabetes, ageing and comorbidity is increasing. This analysis explores the relationship between comorbidities, risk factors and acute glycaemic emergencies.
METHODS: This observational study comprised 24,492 adults with diabetes from the Australian National Diabetes Audit between 2015 and 2022. Cardiovascular risk factors included hypertension, dyslipidaemia, overweight/obesity and smoking. Comorbidities were classified as diabetes-discordant (dementia, depression, malignancy and liver disease) and diabetes-concordant (macrovascular/microvascular diabetes complications). Acute glycaemic emergencies combined diabetic ketoacidosis, hyperosmolar hyperglycaemic state and/or severe hypoglycaemia. We used a mixed effect logistic regression model.
RESULTS: Prevalence of acute glycaemic emergencies was 7.1%. Adjusted analyses showed odds of acute glycaemic emergencies were 73% higher for at least one individual 'comorbidity only' (95% CI 1.23 - 2.42, p = 0.001) compared to without comorbidities/risk factors. 'Discordant comorbidities only' group (OR 2.28, 95% CI 1.54 - 3.37, p < 0.001) and 'concordant comorbidities only' group (OR 1.53, 95% CI 1.10 - 2.13, p = 0.011) maintained increased odds. A dose-dependent relationship was found between total number of comorbidities and acute glycaemic emergencies, with > 4 comorbidities having highest odds (OR 3.71, 95% CI 2.95 - 4.67, p < 0.001).
CONCLUSION: Patients with diabetes and comorbidities are more likely to experience acute glycaemic emergencies. Findings assist clinicians identify patients who would benefit from targeted education to reduce glycaemic emergencies.
PMID:41936945 | DOI:10.1016/j.diabres.2026.113241