Frequency of Severe Hypoglycemia Requiring Emergency Treatment in Type 1 and Type 2 Diabetes

Leese, Graham; Wang, Jixian; Broomhall, J; Kelly, Paul; Marsden, A K; Morrison, William; Frier, Brian M.; Morris, Andrew D.

doi:10.2337/diacare.26.4.1176

Cited by 530 publications

(429 citation statements)

References 24 publications

(18 reference statements)

Supporting

Mentioning

378

Contrasting

Unclassified

Order By: Relevance

“…reported that ~ 30% were referred to hospitals 14. A retrospective analysis of emergency care in a population of nearly 400 000 inhabitants in the UK reported a higher rate of referrals (59%) to the hospital emergency service 27, but in that study, a glucose value < 3.5 mmol/l and parenteral therapy was an inclusion requirement.…”

Section: Discussionmentioning

confidence: 78%

Incidence and care‐related costs of severe hypoglycaemia requiring emergency treatment in Andalusia (Spain): the PAUEPAD project

et al. 2015

View full text Add to dashboard Cite

AimsHypoglycaemia is a serious medical emergency. The need for emergency medical service care and the costs of hypoglycaemic emergencies are not completely known.MethodsThis was a retrospective observational study using Public Company for Health Emergencies (EPES) data for hypoglycaemia in 2012. The EPES provides emergency medical services to the entire population of Andalusia, Spain (8.5 million people). Data on event type, onsite treatments, emergency room visits or hospitalization were collected. Medical costs were estimated using the public rates for healthcare services.ResultsFrom a total of 1 137 738 emergency calls that requested medical assistance, 8683 had a primary diagnosis of hypoglycaemia (10.34 per 10 000 person‐years). The incidence of severe hypoglycaemic episodes requiring emergency treatment in the estimated population with diabetes was 810 episodes per 10 000 person‐years. A total of 7479 episodes (86%) required an emergency team to visit the patient's residence. The majority of cases (64%) were addressed in the residence, although 1784 (21%) cases were transferred to hospital. A total of 5564 events (65%) involved patients aged > 65 years. Overall mortality was 0.32% (28 cases). The total annual cost of attending a hypoglycaemic episode was €6 093 507, leading to an estimated mean direct cost per episode of €702 ± 565. Episodes that required hospital treatment accounted for 49% of the total costs.ConclusionsHypoglycaemia is a common medical emergency that is associated with high emergency medical service utilization, resulting in a significant economic impact on the health system.

show abstract

Section: Discussionmentioning

confidence: 78%

Incidence and care‐related costs of severe hypoglycaemia requiring emergency treatment in Andalusia (Spain): the PAUEPAD project

et al. 2015

View full text Add to dashboard Cite

show abstract

“…There is evidence that frail older patients are prone to severe hypoglycaemia [7,8,23]. Our data indicate that dementia is likely to be an additional major independent contributor to this excess risk with potentially adverse consequences for the individual and the community.…”

Section: Discussionmentioning

confidence: 67%

Severe hypoglycaemia and cognitive impairment in older patients with diabetes: the Fremantle Diabetes Study

et al. 2009

View full text Add to dashboard Cite

Aims/hypothesis The aim was to investigate the relationship between severe hypoglycaemia and cognitive impairment in older patients with diabetes. Methods A sample of 302 diabetic patients aged ≥70 years was assessed for dementia or cognitive impairment without dementia in 2001-2002 and a subsample of non-demented patients (n=205) was followed to assess cognitive decline. A history of severe hypoglycaemia was determined from self-reports, physician assessments and records of health service use for hypoglycaemia (HSH). Prospective HSH was determined up to 2006. Data analysis, including multiple logistic and Cox regression models, was used to determine whether: (1) there were cross-sectional associations between hypoglycaemia and cognitive status, (2) historical hypoglycaemia predicted cognitive decline, and (3) baseline cognitive status predicted subsequent HSH.Results There were significant cross-sectional associations between both cognitive impairment and dementia and hypoglycaemia. Independent risk factors for future HSH included dementia (hazard ratio 3.00, 95% CI 1.06-8.48) and inability to self-manage medications (hazard ratio 4.17, 95% CI 1.43-12.13). However, there were no significant associations between historical hypoglycaemia, incident HSH and cognitive decline. Conclusions/interpretation Dementia is an important risk factor for hypoglycaemia requiring health service utilisation. We found no evidence that hypoglycaemia contributes to cognitive impairment in older patients with diabetes.

show abstract

“…2) were extracted from NHS data 12, two publications 4, 11, and National Institute for Health and Care Excellence (NICE) quality standards 13. The publication by Leese et al .…”

Section: Methodsmentioning

confidence: 99%

“…The publication by Leese et al . 11 is the only publication to give absolute numbers of people using an ambulance, accident and emergency and hospital after severe hypoglycaemic episodes. The publication by Brod et al .…”

Section: Methodsmentioning

confidence: 99%

“…The study by Leese et al . 11 showed that, among severe hypoglycaemic episodes using a NHS hospital over the course of 1 year, 91% required an ambulance, 63% resulted in admission to accident and emergency and 21% required hospitalisation. Upon discharge, patients need to be seen by a healthcare professional, with NICE quality standards recommending a diabetes specialist when medical attention was required 13.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Approach to assessing the economic impact of insulin‐related hypoglycaemia using the novel Local Impact of Hypoglycaemia Tool

et al. 2015

View full text Add to dashboard Cite

AimTo provide estimates of the costs of severe and non‐severe insulin‐related hypoglycaemia in the UK using the Local Impact of Hypoglycaemia Tool.MethodsRates of hypoglycaemia were extracted from the UK Hypoglycaemia Study Group observational study. The costs of severe and non‐severe hypoglycaemic episodes in insulin‐treated adults with Type 1 and Type 2 diabetes were estimated from UK data sources. The rates and costs were then applied to specific populations to give an estimate of the cost of insulin‐related hypoglycaemia for the UK, a specific locality, or a user‐defined population. User‐specific rates and costs could also be applied.ResultsThe estimated cost of a hypoglycaemic episode can range from as much as £2,152 for severe episodes (for which the patient is admitted to hospital) to as little as £1.67 for non‐severe episodes. With a UK population of 64.1 million, the total estimated cost of managing insulin‐related hypoglycaemia is £468.0 m per year (£295.9 m for severe episodes, £172.1 m for non‐severe episodes). On a local health economy level, using a hypothetical general population of 100 000, the total cost of managing insulin‐related hypoglycaemia is estimated to be £730,052 per year (£461,658 for severe and £268,394 for non‐severe episodes).ConclusionsThe Local Impact of Hypoglycaemia Tool highlights the economic burden of insulin‐related hypoglycaemia. Non‐severe episodes are often overlooked because of their low individual cost, but their high frequency makes the cumulative cost substantial. The Local Impact of Hypoglycaemia Tool also shows clinicians and budget‐holders the economic impact of lower rates of hypoglycaemia.

show abstract

Frequency of Severe Hypoglycemia Requiring Emergency Treatment in Type 1 and Type 2 Diabetes

Cited by 530 publications

References 24 publications

Incidence and care‐related costs of severe hypoglycaemia requiring emergency treatment in Andalusia (Spain): the PAUEPAD project

Incidence and care‐related costs of severe hypoglycaemia requiring emergency treatment in Andalusia (Spain): the PAUEPAD project

Severe hypoglycaemia and cognitive impairment in older patients with diabetes: the Fremantle Diabetes Study

Approach to assessing the economic impact of insulin‐related hypoglycaemia using the novel Local Impact of Hypoglycaemia Tool

Contact Info

Product

Resources

About