title: Hypoglycemia and Medical Expenses in Patients with Type 2 Diabetes Mellitus: An Analysis Based on the Korea National Diabetes Program Cohort.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Sang Youl
authors.initials: SY
authors.lastname: Rhee
authors.affiliation: Department of Endocrinology and Metabolism, Graduate School of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: Soo Min
authors.initials: SM
authors.lastname: Hong
authors.affiliation: Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Suk
authors.initials: S
authors.lastname: Chon
authors.affiliation: Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Kyu Jeung
authors.initials: KJ
authors.lastname: Ahn
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sei Hyun
authors.initials: SH
authors.lastname: Baik
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea.
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
authors.forename: Moon Suk
authors.initials: MS
authors.lastname: Nam
authors.affiliation: Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Kwan Woo
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Jeong-Taek
authors.initials: JT
authors.lastname: Woo
authors.affiliation: Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Young Seol
authors.initials: YS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology