title: The economic impact of insulin-related hypoglycemia in Denmark: an analysis using the Local Impact of Hypoglycemia Tool.
abstract: OBJECTIVE
  To estimate the direct cost of hypoglycemia in insulin-treated adults with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in Denmark.
  
  
  METHODS
  The Local Impact of Hypoglycemia Tool (LIHT) was used to estimate the costs associated with insulin-related hypoglycemia. Average utilization of healthcare resources, including the costs of pre-hospitalization, hospital admission, healthcare professional contact and follow-up, glucose/glucagon, and extra SMBG tests to monitor blood glucose following an episode, was used to calculate an average cost per severe and per non-severe hypoglycemic episode. The cost per episode was then applied to the rates of severe and non-severe hypoglycemia in people with T1DM and T2DM in Denmark.
  
  
  RESULTS
  The direct cost of insulin-related hypoglycemia in Denmark is DKK 96.2 million per year, which equates to EUR 12.9 million. For people with T1DM prone to severe hypoglycemia (defined as having ≥2 severe episodes in the past year), the cost per person per year increases by DKK 4,155 compared with the T1DM population average, and for people with T2DM prone to non-severe hypoglycemia (defined as having ≥1 non-severe episode in the last 4 weeks), the cost increases by DKK 647 per person per year compared with the T2DM population average.
  
  
  CONCLUSIONS
  The LIHT highlights the substantial economic burden of insulin-related hypoglycemia in Denmark, and provides a means to estimate the savings that could be made by lowering hypoglycemia rates. For example, the costs associated with using a new insulin or introducing a patient education program could be offset with the cost saving from reducing hypoglycemia.
authors.affiliation: a DRG Abacus , Bicester, Oxon , UK.
authors.forename: Nicki
authors.initials: N
authors.lastname: Hoskins
authors.affiliation: b Novo Nordisk, Novo Nordisk Health Care AG , Zurich , Switzerland.
authors.forename: Christian Klyver
authors.initials: CK
authors.lastname: Tikkanen
authors.affiliation: c Department of Cardiology, Nephrology & Endocrinology , Nordsjællands Hospital Hillerød , Denmark.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Pedersen-Bjergaard
mesh_terms: D001786:Blood Glucose; D015190:Blood Glucose Self-Monitoring; D003362:Cost-Benefit Analysis; D003718:Denmark; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005102:Health Expenditures; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000191:economics*; D007328:Insulin / Q000009:adverse effects* / Q000627:therapeutic use; D017059:Models, Econometric; D012720:Severity of Illness Index
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Denmark; Hypoglycemia; cost savings; diabetes mellitus; economic burden; insulin