Hypoglycemia and Medical Expenses in Patients with Type 2 Diabetes Mellitus: An Analysis Based on the Korea National Diabetes Program Cohort

• Published in: PloS one 2016-02, Vol.11 (2), p.e0148630-e0148630
• Main Authors: Rhee, Sang Youl, Hong, Soo Min, Chon, Suk, Ahn, Kyu Jeung, Kim, Sung Hoon, Baik, Sei Hyun, Park, Yong Soo, Nam, Moon Suk, Lee, Kwan Woo, Woo, Jeong-Taek, Kim, Young Seol
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cardiovascular disease; Care and treatment; Cohort Studies; Complications and side effects; Costs; Databases, Factual; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Economic aspects; Endocrinology; Female; Follow-Up Studies; Glucose; Health care; Health care costs; Health Care Costs - statistics & numerical data; Health care policy; Hospitals; Humans; Hypoglycemia; Hypoglycemia - diagnosis; Hypoglycemia - epidemiology; Hypoglycemia - etiology; Incidence; Insulin; Internal medicine; Male; Medical records; Medicine; Medicine and Health Sciences; Metabolism; Middle Aged; Patients; People and Places; Quality of life; Republic of Korea - epidemiology; Risk factors; Studies; Type 2 diabetes
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0148630

Hypoglycemia is one of the most important adverse events in individuals with type 2 diabetes mellitus (T2DM). However, hypoglycemia-related events are usually overlooked and have been documented less in clinical practice. We evaluated the incidence, clinical characteristics, and medical expenses of hypoglycemia related events in T2DM patients based on the Korea National Diabetes Program (KNDP), which is the largest multi-center, prospective cohort in Korea (n = 4,350). For accurate outcomes, the KNDP data were merged with claims data from the Health Insurance Review and Assessment Service (HIRA) of Korea. During a median follow-up period of 3.23 years (95% CI: 3.14, 3.19), 88 subjects (2.02%) were newly diagnosed with hypoglycemia, and the incidence of hypoglycemia was 6.44 cases per 1,000 person-years (PY). Individuals with hypoglycemia were significantly older (59.7±10.7 vs. 53.3±10.4 years, p < 0.001), had more hospital visits (121.94±126.88 days/PY, p < 0.001), had a longer hospital stays (16.13±29.21 days/PY, p < 0.001), and incurred greater medical costs ($2,447.56±4,056.38 vs. $1,336.37±3,403.39 /PY, p < 0.001) than subjects without hypoglycemia. Hypoglycemia-related events were infrequently identified among the medical records of T2DM subjects. However, they were associated significantly with poor clinical outcomes, and thus, hypoglycemia could have a substantial burden on the Korean national healthcare system.