218-LB: Hypoglycemia Burden in T2D Patients: Rationale, Methodology, and Comparative Results of a Multisetting Nationwide Study Series

Abstract

Introduction: Hypoglycemia places a significant burden, accounting for adverse clinical and financial outcomes. Objective: Integrated approach to determine burden of hypoglycemia in T2D patients in Portugal, accessed in an Outpatient Setting (pharmacies), Emergency Rooms (ERs) and Hospital Wards, contributing for a full country perspective of complementary settings. Methods: A series of 3 HypoglycemIa in POrtugal Studies (HIPOS) were developed: HIPOS-PHARMA, HIPOS-ER and HIPOS-WARD. They were observational, cross-sectional, multicentric studies designed to evaluate adult T2D patients treated with AHA attending pharmacies and reporting hypoglycemic events (PHARMA), admitted in ERs or hospitalized (WARD) for hypoglycemia. These studies were implemented over a period of non-consecutive 35 months (Jan13-Aug18) and with a national coverage. Results: Mild to moderate hypoglycemia in the 3 months prior recruitment were reported by 17.8% of the 1890 individuals enrolled by 233 pharmacies during HIPOS-PHARMA and were more likely in patients taking insulin and/or secretagogues. Only 46% of patients reported the episode to a HCP. Severe hypoglycemia accounted for 0.074% (n=238) of the 425,706 ER admissions in the 7 HIPOS-ER hospitals and occurred mainly on insulin- (55.0%) and secretagogue-based therapy (31.5%). When these patients needed hospitalization (44%), the mean total cost per hypoglycemic event was € 3,163 (€ 230 - € 26,818). As for HIPOS-WARD, 152 individuals were enrolled in 18 centers, 40.4% had previous hypoglycemia (last 12 months), and were also on insulin (42.1%) or secretagogues (34.9%). Conclusion: This study series allowed for the first time a nationwide multi-setting perspective of hypoglycemia in T2D patients, signaling that this event still represents a relevant burden in Portugal, despite significant improvements in hypoglycemia prevention strategies and the growing number AHA with low hypoglycemia risk. Disclosure S. Alão: Employee; Self; Merck Sharp & Dohme Corp. L.C. Santos: Speaker’s Bureau; Self; Merck Sharp & Dohme Corp. F. Araujo: None. J.M. Dores: Advisory Panel; Self; Merck Sharp & Dohme Corp. J. Pelicano-Romano: Employee; Self; Merck & Co., Inc. J.M. Conceicao: Employee; Self; Merck Sharp & Dohme Corp. Stock/Shareholder; Self; Merck Sharp & Dohme Corp. P. Mj: Employee; Self; Merck Sharp & Dohme Corp.