Hypoglycemia, treatment discontinuation, and costs in patients with type 2 diabetes mellitus on oral antidiabetic drugs.
OBJECTIVE
To investigate the rate and impact of hypoglycemic events among patients with type 2 diabetes mellitus (T2DM) receiving different classes of oral antidiabetic drugs (OADs).


METHODS
Adult patients with T2DM were extracted from the Ingenix IMPACT claims database. The mean number of health care visits due to hypoglycemic events per patient-year was estimated. Multivariate regression models were used to: 1) assess the risk factors for experiencing a hypoglycemic event; 2) assess the effect of experiencing hypoglycemic events on antidiabetic treatment discontinuation; and 3) compare 12-month post-index date costs between patients with and without hypoglycemic events.


RESULTS
212 061 patients with T2DM were included in the analysis. The estimated frequency of hypoglycemia-related health care visits was 0.054 per patient-year. Insulin use was associated with increased risk of developing hypoglycemia, followed by use of sulfonylureas and other OADs (eg, meglitinide and α-glucosidase inhibitors). The impacts of thiazolidinediones, metformin, and dipeptidyl peptidase-4 on hypoglycemia risk were relatively small. Having a hypoglycemic event was associated with significantly increased risk of antidiabetic treatment discontinuation. Patients with hypoglycemia showed significantly higher annual all-cause and diabetes-related health care costs than patients without hypoglycemia (adjusted Δ = +$5024 and +$3747, respectively; both P < 0.0001).


CONCLUSIONS
Different OAD classes were associated with different levels of risk for hypoglycemic events. Hypoglycemia was associated with a higher risk of antidiabetic treatment discontinuation and significantly increased health care costs.
Takeda Pharmaceuticals International, Inc., Deerfield, IL, USA.
Morgan
M
Bron
Maryna
M
Marynchenko
Hongbo
H
Yang
Andrew P
AP
Yu
Eric Q
EQ
Wu
D000284:Administration, Oral; D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000191:economics; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000191:economics / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000191:economics / Q000627:therapeutic use; D007328:Insulin / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013453:Sulfonylurea Compounds / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use
D007004:Hypoglycemic Agents; D007328:Insulin; D013453:Sulfonylurea Compounds