Hypoglycemia hospitalization frequency in patients with type 2 diabetes mellitus: a comparison of dipeptidyl peptidase 4 inhibitors and insulin secretagogues using the French health insurance database

• Published in: Vascular health and risk management 2015-01, Vol.11 (default), p.417-425
• Main Authors: Detournay, Bruno, Halimi, Serge, Robert, Julien, Deschaseaux, Céline, Dejager, Sylvie
• Format: Article
• Language: English
• Subjects: Adamantane - analogs & derivatives; Adamantane - therapeutic use; Aged; Aged, 80 and over; Cardiac arrhythmia; Complications and side effects; Databases, Factual; Diabetes; Diabetes Mellitus, Type 2 - complications; Dipeptidyl-Peptidase IV Inhibitors - therapeutic use; Emergency Service, Hospital - utilization; Endocrinology; Expenditures; Female; Forecasts and trends; France - epidemiology; Glucose; Health care policy; Health insurance; Hospitalization; Hospitalization - statistics & numerical data; Hospitals; Humans; Hyperglycemia; Hypoglycemia; Hypoglycemia - complications; Hypoglycemia - drug therapy; Hypoglycemia - epidemiology; Insulin; Insurance, Health; Longitudinal studies; Male; Middle Aged; Mortality; Nitriles - therapeutic use; Original Research; Patients; Population; Pyrrolidines - therapeutic use; Regression Analysis; Risk factors; Sociodemographics; Sulfonylurea Compounds; Type 2 diabetes
• ISSN: 1178-2048; 1176-6344; 1178-2048
• DOI: 10.2147/VHRM.S84507

We aimed to compare the frequency of severe hypoglycemia leading to hospitalization (HH) and emergency visits (EV) for any cause in patients with type 2 diabetes mellitus exposed to dipeptidyl peptidase 4 (DPP4) inhibitors (DPP4-i) versus those exposed to insulin secretagogues (IS; sulfonylureas or glinides). Data were extracted from the EGB (Echantillon Généraliste des Bénéficiaires) database, comprising a representative sample of ~1% of patients registered in the French National Health Insurance System (~600,000 patients). Type 2 diabetes mellitus patients exposed to regimens containing either a DPP4-i (excluding treatment with IS, insulin, or glucagon-like peptide 1 analog) or IS (excluding treatment with insulin and any incretin therapy) between 2009 and 2012 were selected. HH and EV during the exposure periods were identified in both cohorts. A similar analysis was conducted considering vildagliptin alone versus IS. Comparative analyses adjusting for covariates within the model (subjects matched for key characteristics) and using multinomial regression models were performed. Overall, 7,152 patients exposed to any DPP4-i and 1,440 patients exposed to vildagliptin were compared to 10,019 patients exposed to IS. Eight patients (0.11%) from the DPP4-i cohort and none from the vildagliptin cohort (0.0%) were hospitalized for hypoglycemia versus 130 patients (1.30%) from the IS cohort (138 hospitalizations) (P=0.02 and P