Iatrogenic hypoglycemia–related hospital admissions identified through databases: economic burden and causes

Background Hypoglycemia is an acute and frequent complication of diabetes. Objectives To assess the number of hospital admissions due to iatrogenic hypoglycemia in Alsace (France) over a year, to estimate the associated economic burden and to identify causes. Method A retrospective analysis was performed using data extracted from hospital databases. Costs were calculated from French official tariffs. Setting 31 public and private hospitals. A review of the medical records of patients with iatrogenic hypoglycemia-related hospital admissions was performed at the University Hospital of Strasbourg. Main outcome measures Hypoglycemia–related hospital admissions: number, costs and causes. Results Out of 42,381 hospitalizations, 147 iatrogenic hypoglycemia–related hospital admissions (0.4%) were identified; 41 patients with type 1 diabetes mellitus and 106 with type 2. The total cost associated to the 147 events was € 407,441. The median cost per patient was € 1,224.6 [563.0–2,505.7 (interquartile range)] for type 1 diabetes mellitus and € 3,670.9 [2,505.7–3,670.9] for type 2. Forty-six patients over the 147 were coming from the University Hospital of Strasbourg. In this hospital, the most common origin of the hypoglycemia was missed meals (n = 7), the second was a mismatch between antidiabetic medicines and carbohydrate intake (n = 6), the third was an incorrect use of antidiabetic medicines (n = 5). Conclusions 147 hospitalizations due to iatrogenic hypoglycemia were identified with an estimated global cost of € 407,441. Optimizing therapy with low-risk hypoglycemic medicines, improving access to continuous glucose monitoring systems and offering adequate education, could help address the causes of hypoglycemia.