title: Secular Trends in the Clinical Characteristics of Type 2 Diabetic Patients With Severe Hypoglycemia Between 2008 and 2013.
abstract: BACKGROUND
  We investigated the trends in the clinical characteristics and prescriptions of type 2 diabetic patients with severe hypoglycemia because the prescription rate of antidiabetic agents has significantly changed recently.
  
  
  METHODS
  A total of 193 patients with type 2 diabetes with severe hypoglycemia induced by antidiabetic agents between 2008 and 2013 were divided into three groups based on the period of visit: 2008 - 2009, 2010 - 2011 and 2012 - 2013.
  
  
  RESULTS
  While the proportion of patients with severe hypoglycemia using insulin (from 55% to 74%), biguanides (from 6% to 20%), glinides, and dipeptidyl peptidase-4 inhibitors significantly increased, those using sulfonylureas (from 45% to 20%) significantly decreased. Errors of drug use significantly increased as a trigger of hypoglycemia in recent years. The number of antidiabetic agents (from 1.9 ± 0.6 to 2.3 ± 0.7), non-diabetic agents (from 2.3 ± 2.4 to 4.3 ± 3.3), and total drugs prescribed were significantly higher in recent years among patients receiving insulin therapy.
  
  
  CONCLUSIONS
  Polypharmacy especially in patients receiving insulin therapy and errors of drug use have increased in type 2 diabetic patients with severe hypoglycemia in recent years. Intensive education in the usage rule of drugs is considered to be important in order to prevent severe hypoglycemia.
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ito
authors.affiliation: Department of Pharmacy, Edogawa Hospital, Tokyo, Japan.
authors.forename: Emiko
authors.initials: E
authors.lastname: Tsugami
authors.affiliation: Department of Pharmacy, Edogawa Hospital, Tokyo, Japan.
authors.forename: Shigenori
authors.initials: S
authors.lastname: Ando
authors.affiliation: Department of Pharmacy, Edogawa Hospital, Tokyo, Japan.
authors.forename: Ayano
authors.initials: A
authors.lastname: Imai
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Suzuko
authors.initials: S
authors.lastname: Matsumoto
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Omoto
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shinozaki
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Nishio
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Abe
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Antoku
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Mizuo
authors.initials: M
authors.lastname: Mifune
authors.affiliation: Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Togane
keywords: Hypoglycemia; Insulin; Patient education; Polypharmacy; Sulfonylureas