Risk of Hypoglycemia and Associated Factors Among In-Hospital Chinese Patients With Latent Autoimmune Diabetes in Adults (LADA): A Multicenter Retrospective Cohort Study.

Authors

Haojie Zhou, Qiang Zhang, Guniqing Zhu, Weiwei Xu, Xueyan Zhao, Xiangfu Gu, Xiaoyu Cai, Xiaoli Zhu, Ran Li

Published in

Journal of diabetes research. Volume 2026. Issue 1. Pages e2961800.

Abstract

Latent autoimmune diabetes in adults (LADA) is characterized by progressive β-cell dysfunction and glycemic lability, which increases susceptibility to in-hospital hypoglycemia. Real-world data on the epidemiology of hypoglycemia and associated factors among LADA inpatients are limited, particularly among multiethnic populations in Southwest China. This study is aimed at exploring the prevalence, regional heterogeneity, and independent associated factors of in-hospital hypoglycemia in the LADA population.
Following the STROBE guidelines, 709 hospitalized patients with LADA from five tertiary hospitals in Southwest China from January 2019 to September 2025 were enrolled retrospectively. Missing data were imputed via multiple imputation by chained equations with results pooled using Rubin's rules. Univariate logistic regression was applied for preliminary factor screening. Multicollinearity was evaluated prior to multivariate regression. Model performance was assessed using the AUC for discriminative ability and Nagelkerke's R² for goodness of fit, with subset sensitivity analysis performed to verify result robustness.
The overall in-hospital hypoglycemia incidence was 47.39%, with evident regional heterogeneity across Southwest China. After pooling results from 20 imputed datasets, seven independently associated factors were identified. These factors included insulin pump therapy (OR = 8.233, 95% CI: 3.914-17.274), the largest amplitude of glycemic excursions (OR = 1.136, 95% CI: 1.081-1.193), length of hospital stay (OR = 1.134, 95% CI: 1.074-1.197), prior hypoglycemia history (OR = 2.447, 95% CI: 1.448-4.024), sex (OR = 1.655, 95% CI: 1.065-2.574), geographic origin (OR = 0.369, 95% CI: 0.225-0.605), and glycated hemoglobin (OR = 0.902, 95% CI: 0.837-0.973). The median AUC and Nagelkerke's R² demonstrated satisfactory discrimination and calibration of the final model.
Hospitalized LADA patients in Southwest China have a high prevalence of in-hospital hypoglycemia with prominent regional disparities. The identified associated factors support individualized risk stratification, targeted glycemic monitoring, and optimized inpatient management, helping reduce hypoglycemia burden and improve glycemic safety among hospitalized LADA patients.

PMID:
42370537
Bibliographic data and abstract were imported from PubMed on 29 Jun 2026.

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