Hypoglycemia hospitalizations increased from 1998 to 2013 in England
Hospitalizations for hypoglycemia increased by roughly 4% among adults with type 1 diabetes and young and middle-aged adults with type 2 diabetes from 1998 to 2013, but that trend reversed in older adults with type 2 diabetes beginning in 2009, according to results of a retrospective cohort study of patients in England.
Victor W. Zhong, PhD, of The University of North Carolina at Chapel Hill, and colleagues evaluated data from the Clinical Practice Research Datalink on 23,246 U.K. adults with type 1 diabetes and 241,441 with type 2 diabetes to determine trends in hospitalization for hypoglycemia. Data on hypoglycemia as a primary reason for hospitalization between 1998 and 2013 were collected from Hospital Episode Statistics for patients in England. Join-point regression models were used to estimate trends for adults with type 1 diabetes, young and middle-aged adults with type 2 diabetes (aged 18-64 years) and older adults with type 2 diabetes (aged 65 years and older).
Overall, 1,591 hypoglycemia hospitalizations occurred during 121,262 follow-up years in participants with type 1 diabetes, 553 occurred during 560,686 person-years of follow-up in young and middle-aged adults with type 2 diabetes, and 3,185 occurred during 784,132 person-years of follow-up in older adults with type 2 diabetes.
Between 1998 and 2013, the incidence of hospitalizations for hypoglycemia increased from 9.57 per 1,000 person-years to 14.8 per 1,000 person-years in participants with type 1 diabetes for an annual percent increase of 3.74% (P = .001). The incidence of hypoglycemia hospitalization in young and middle-aged adults with type 2 diabetes increased from 0.73 per 1,000 person-years to 1.19 per 1,000 person-years between 1998 and 2013 for an annual percent increase of 4.12% (P = .02). The incidence in older adults with type 2 diabetes increased from 1.12 per 1,000 person-years to 3.52 per 1,000 person-years for an annual percent increase of 8.59% from 1998 to 2009 (P < .0001); however, incidence decreased by 8.05% annually from 2009 to 2013.
“Practical approaches for hypoglycemia management to reverse the increasing trend of hypoglycemia hospitalization in England are critically needed,” the researchers wrote. “Studies that are able to investigate diabetes type-specific longitudinal trends of severe hypoglycemia not resulting in hospital admission are encouraged. Also, future work is needed to better understand the contributors of the hypoglycemia trends in England, including the decline from 2009 in elderly patients with [type 2 diabetes].” – by Amber Cox
Disclosures: Mayer-Davis reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.