Abstract
the 2009 dataset for validation. Results: In 2008, there were 53.4 million (95% CI 45.4 million 61.6 million) visits for T2DM. Of these, 658,767 (95% CI 234,319 1,083,215) were for hypoglycemia and 152,751 (95% CI: 0-350,141) were for gastroparesis. When adjusted for payor status, age, gender, comorbidities and medication use, gastroparesis was associated with a significantly lower risk of hypoglycemia. Validation with 2009 data revealed a concordance of 88% between predicted and observed hypoglycemia events. Conclusions: T2DM patient visits with gastroparesis were associated with a significantly lower risk of hypoglycemia compared to those without gastroparesis. Due to sampling design and the rarity of gastroparesis, there were very few sampled visits with gastroparesis, resulting in large confidence intervals. Thus, the results need to be confirmed in larger samples. Another limitation is that these analyses are based on cross-sectional data and laboratory confirmation of hypogyemia was not available. While gastoparesis is often associated with labile glycemic control, these results are consistent with the mechanism of action of GLP-1 receptor agonists, which blunt postprandial hyperglycemia by slowing gastric emptying without causing hypoglycemia.
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