Hypoglycemia-Related Emergency Department Visits and Hypoglycemia-Related Hospitalizations among New Users of Antidiabetes Treatments

Abstract

To describe the burden of severe hypoglycemia among new users of insulin and oral antidiabetes drugs (OAD) in terms of 2 hypoglycemia-related outcomes: emergency department (ED) visit and hospitalization. We conducted an inception cohort study using the databases of the Quebec health insurance board and the Quebec registry of hospitalizations. The source population was made of individuals 18 years of age or older who were newly dispensed an antidiabetes treatment made of either insulin or OAD between January 1, 2000 and December 31, 2008. Individuals were followed from initiation of antidiabetes treatment to December 31, 2008, occurrence of hypoglycemia-related outcome, loss of eligibility to the drug plan or death, whichever came first. Individuals' characteristics at antidiabetes treatment initiation were described using frequency distributions. The incidence rate for the occurrence of hypoglycemia-related ED visit and hypoglycemia-related hospitalization were calculated using the Kaplan-Meier method. A total of 188 659 new users of antidiabetes treatment were included in the cohort. A total of 3575 (1.9%) individuals had at least 1 hypoglycemia-related ED visit whereas 194 (0.1%) had at least 1 hypoglycemia-related hospitalization. Incidence rates for the occurrence of hypoglycemia-related ED visits and hypoglycemia-related hospitalizations were 5.2 and 0.3 cases per 1000 patient years, respectively. Although the incidence of ED visit or hospitalization due to hypoglycemia seems low, severe hypoglycemia episodes could be associated with a high economic burden.