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Multicenter Study
. 2016 Feb 18;11(2):e0148630.
doi: 10.1371/journal.pone.0148630. eCollection 2016.

Hypoglycemia and Medical Expenses in Patients with Type 2 Diabetes Mellitus: An Analysis Based on the Korea National Diabetes Program Cohort

Sang Youl Rhee  1 , Soo Min Hong  2 , Suk Chon  1 , Kyu Jeung Ahn  1 , Sung Hoon Kim  3 , Sei Hyun Baik  4 , Yong Soo Park  5 , Moon Suk Nam  6 , Kwan Woo Lee  7 , Jeong-Taek Woo  1 , Young Seol Kim  1
Affiliations
Multicenter Study

Hypoglycemia and Medical Expenses in Patients with Type 2 Diabetes Mellitus: An Analysis Based on the Korea National Diabetes Program Cohort

Sang Youl Rhee et al. PLoS One. .

Abstract

Background and aims: Hypoglycemia is one of the most important adverse events in individuals with type 2 diabetes mellitus (T2DM). However, hypoglycemia-related events are usually overlooked and have been documented less in clinical practice.

Materials and methods: We evaluated the incidence, clinical characteristics, and medical expenses of hypoglycemia related events in T2DM patients based on the Korea National Diabetes Program (KNDP), which is the largest multi-center, prospective cohort in Korea (n = 4,350). For accurate outcomes, the KNDP data were merged with claims data from the Health Insurance Review and Assessment Service (HIRA) of Korea.

Results: During a median follow-up period of 3.23 years (95% CI: 3.14, 3.19), 88 subjects (2.02%) were newly diagnosed with hypoglycemia, and the incidence of hypoglycemia was 6.44 cases per 1,000 person-years (PY). Individuals with hypoglycemia were significantly older (59.7±10.7 vs. 53.3±10.4 years, p < 0.001), had more hospital visits (121.94±126.88 days/PY, p < 0.001), had a longer hospital stays (16.13±29.21 days/PY, p < 0.001), and incurred greater medical costs ($2,447.56±4,056.38 vs. $1,336.37±3,403.39 /PY, p < 0.001) than subjects without hypoglycemia.

Conclusion: Hypoglycemia-related events were infrequently identified among the medical records of T2DM subjects. However, they were associated significantly with poor clinical outcomes, and thus, hypoglycemia could have a substantial burden on the Korean national healthcare system.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Subjects with T2DM enrolled based on the Korea National Diabetes Program (KNDP) cohort data.
Fig 2
Fig 2. Comparisons between subjects with and without hypoglycemia after adjusting for age, follow-up period, duration of diabetes, recuperation period, BMI, cerebrovascular disease, DM medication, antihypertensive medication, TG, and ALT levels.
(A) Number of hospital visits. (B) Length of hospital stays. (C) Medical expenses.
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