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BMC Health Services Research
Published in: BMC Health Services Research 1/2015

Open Access 01-12-2015 | Research article

Incidence of severe hypoglycaemic episodes in patients with type 2 diabetes in the Basque country: impact on healthcare costs

Authors: Edurne Alonso-Morán, Juan F. Orueta, Roberto Nuño-Solinís

Published in: BMC Health Services Research | Issue 1/2015

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Abstract

Background

Hypoglycaemia is an acute complication of diabetes mellitus which poses a serious threat. This study aims to describe the annual rate of people suffering episodes of severe hypoglycaemia and to estimate the healthcare costs for individuals who have suffered such events.

Methods

A descriptive study involving all patients with type 2 diabetes (T2DM) from the Basque Country (period: 1/09/2010 to 31/08/2011) aged ≥35 years (N = 134,413). The rate of hypoglycaemic episodes treated in hospitals (Accident and Emergency and in-patient services) was calculated using an algorithm based on diagnostics and laboratory tests. The variables recorded included demographic, comorbidity (diagnoses categorised using the Adjusted Clinical Groups case-mix system) and socioeconomic variables (deprivation index of the area of residence). The annual healthcare cost for people with T2DM who suffered those episodes was compared with those who did not by regression analysis.

Results

The incidence of hypoglycaemia in the Basque Country was 0.56 %. This percentage was higher among women and people with a lower socioeconomic status. These episodes were associated with age and high values of glycosylated haemoglobin (HbA1c) > 7 %. Adjusting for the other variables, on average, people who suffered hypoglycaemia accounted for an additional €2509 in annual healthcare costs.

Conclusions

Hypoglycaemia has high morbi-mortality and a major economic impact. As such, health services must monitor its appearance and promote specific actions, especially in the higher risk sub-populations.
Literature
1.
2.
3.
Landstedt-Hallin L, Adamson U, Lins P. Oral glibenclamide suppresses glucagon secretion during insulin-induced hypoglycemia in patients with type 2 diabetes*. J Clin Endocrinol Metab Copyr. 1999;84:3140–5.
4.
Desouza C, Salazar H, Cheong B, Murgo J, Fonseca V. Association of hypoglycemia and cardiac ischemia: a study based on continuous monitoring. Diabetes Care. 2003;26(5):1485–9.CrossRefPubMed
5.
Lawrence PA, Cheely J. Deterioration of diabetic patients’ knowledge and management skills as determined during outpatient visits. Diabetes Care. 1980;3(2):214–8.CrossRefPubMed
6.
Zammit NN, Frier BM. Hypoglycemia in type 2 diabetes: pathophysiology, frequency, and effects of different treatment modalities. Diabetes Care. 2005;28(12):2948–61.CrossRef
7.
Brito-Sanfiel M, Diago-Cabezudo J, Calderon A. Economic impact of hypoglycemia on healthcare in Spain. Expert Rev Pharmacoeconomics Outcomes Res. 2010;10(6):649–60.CrossRef
8.
Leese GP, Wang J, Broomhall J, Kelly P, Marsden A, Morrison W, et al. Frequency of severe hypoglycemia requiring emergency treatment in type 1 and type 2 diabetes: a population-based study of health service resource use. Diabetes Care. 2003;26(4):1176–80.CrossRefPubMed
9.
10.
11.
12.
Orueta J, Mateos Del Pino M, Barrio Beraza I, Nuño Solinis R, Cuadrado Zubizarreta M, Sola Sarabia C. Estratificación de la población en el País Vasco: resultados en el primer año de implantación. Aten Primaria. 2013;45(1):54–60.CrossRefPubMed
13.
Domínguez-Berjón M, Borrell C, Cano-Serral G, Esnaola S, Nolasco A, Pasarín M, et al. Construcción de un índice de privación a partir de datos censales en grandes ciudades españolas (Proyecto MEDEA). Gac Sanit. 2008;22(3):179–87.CrossRefPubMed
14.
15.
Ginde AA, Blanc PG, Lieberman RM, Camargo CA. Validation of ICD-9-CM coding algorithm for improved identification of hypoglycemia visits. BMC Endocr Disord. 2008;8:4.CrossRefPubMedPubMedCentral
16.
MacLeod KM, Hepburn DA, Frier BM. Frequency and morbidity of severe hypoglycaemia in insulin-treated diabetic patients. Diabet Med. 1993;10(3):238–45.CrossRefPubMed
17.
Donnelly LA, Morris AD, Frier BM, Ellis JD, Donnan PT, Durrant R, et al. Frequency and predictors of hypoglycaemia in Type 1 and insulin-treated Type 2 diabetes: a population-based study. Diabet Med.22(6):749–55.
18.
Wright AD, Cull CA, Macleod MK, Holman RR. Hypoglycemia in Type 2 diabetic patients randomized to and maintained on monotherapy with diet, sulfonylurea, metformin, or insulin for 6 years from diagnosis: UKPDS73. J Diabetes Complications. 2006;20(6):395-401.
19.
Miller CD, Phillips LS, Ziemer DC, Gallina DL, Cook CB, El-Kebbi IM. Hypoglycemia in patients with type 2 diabetes mellitus. Arch Intern Med. 2001;161:1653–9.CrossRefPubMed
20.
Quilliam BJ, Simeone JC, Ozbay AB, Stephen JK. The incidence and costs of hypoglycemia in type 2 diabetes. Am J Manag Care. 2011;17(10):673–80.PubMed
21.
Hammer M, Lammert M, Monereo Mejías S, Kern W, Frier BM. Costs of managing severe hypoglycaemia in three European countries. J Med Econ. 2009;12(4):281–90.CrossRefPubMed
22.
Orueta JFM, Lopez-De-Munain JMM, Baez KM, Aiarzaguena JMMP[S], Aranguren JIM[P], Pedrero EM[S]. Application of the ambulatory care groups in the primary care of a European national health care system: does it work? Med Care. 1999;37(3):238–48.CrossRefPubMed
23.
Lee W-C, Huang T-P. Explanatory ability of the ACG system regarding the utilization and expenditure of the national health insurance population in Taiwan--a 5-year analysis. J Chin Med Assoc. 2008;71(4):191–9.CrossRefPubMed
24.
Aubé-Maurice J, Rochette L, Blais C. Divergent associations between incident hypertension and deprivation based on different sources of case identification. Chronic Dis Inj Can. 2012;32(3):121–30.PubMed
25.
Van den Bussche H, Schäfer I, Wiese B, Dahlhaus A, Fuchs A, Gensichen J, et al. A comparative study demonstrated that prevalence figures on multimorbidity require cautious interpretation when drawn from a single database. J Clin Epidemiol. 2013;66(2):209–17.CrossRefPubMed
26.
Orueta JF, Nuño-Solinis R, Mateos M, Vergara I, Grandes G, Esnaola S. Monitoring the prevalence of chronic conditions: which data should we use? BMC Health Serv Res. 2012;12(1):365.CrossRefPubMedPubMedCentral
27.
Martín Vaquero P, Barquiel Alcalá B, Puma Duque MA, Liboa Catlán A. Hipoglucemias leves y graves en la diabetes mellitus tipo 1 y 2. Av Diabetol. 2009;25:269–79.
Metadata
Title
Incidence of severe hypoglycaemic episodes in patients with type 2 diabetes in the Basque country: impact on healthcare costs
Authors
Edurne Alonso-Morán
Juan F. Orueta
Roberto Nuño-Solinís
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-0876-2

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