title: The incidence and costs of hypoglycemia in type 2 diabetes.
abstract: OBJECTIVE
  To estimate the rate and costs of hypoglycemia in patients with type 2 diabetes.
  
  
  METHODS
  We used a retrospective cohort design to assess the rate and costs of hypoglycemia among working-age patients with type 2 diabetes in the 2004 to 2008 MarketScan database.
  
  
  METHODS
  We followed patients from cohort entry to the first instance of hypoglycemia requiring medical intervention (inpatient, emergency department [ED], or outpatient) and calculated incidence rates (IRs), stratifying these estimates by age (18-34, 35-49, 50-64, and 65+ years) and gender. We calculated inflation-adjusted total and mean direct costs of medical visits for hypoglycemia, other diabetes-related visits, and all other medical visits.
  
  
  RESULTS
  The cohort was composed of 536,581 members with approximately 1.21 million person years (p-yrs) of follow-up. The IR of hypoglycemic events leading to an inpatient admission, ED, or outpatient visit was 153.8/10,000 p-yrs. The IRs of hypoglycemic events were highest in adults aged 18 to 34 years (218.8/10,000 p-yrs). Regardless of age group, rates of hypoglycemia were greater in women than in men (P < .001). Total hypoglycemia costs were $52,223,675 over the study period and accounted for 1.0% of all inpatient costs, 2.7% of ED costs, and 0.3% of outpatient costs. The mean costs for hypoglycemia visits were $17,564 for an inpatient admission, $1387 for an ED visit, and $394 for an outpatient visit.
  
  
  CONCLUSIONS
  The overall incidence of visits for hypoglycemia was considerable in this large database, and was associated with high per-episode costs. Continued vigilance and the development of strategies to decrease potentially avoidable hypoglycemic episodes requiring medical intervention are needed.
authors: College of Pharmacy, University of Rhode Island, Kingston, RI 02881, USA. bquilliam@uri.edu
authors: Brian J
authors: BJ
authors: Quilliam
authors: Jason C
authors: JC
authors: Simeone
authors: A Burak
authors: AB
authors: Ozbay
authors: Stephen J
authors: SJ
authors: Kogut
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000191:economics* / Q000453:epidemiology; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007003:Hypoglycemia / Q000191:economics* / Q000453:epidemiology / Q000209:etiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult