International Journal of Clinical Pharmacy

, Volume 41, Issue 5, pp 1159–1165 | Cite as

Iatrogenic hypoglycemia–related hospital admissions identified through databases: economic burden and causes

  • Tiphaine Richard
  • Romane Issa
  • Emmanuel Andres
  • Bénédicte Gourieux
  • Nathalie Jeandidier
  • Bruno MichelEmail author
Research Article


Background Hypoglycemia is an acute and frequent complication of diabetes. Objectives To assess the number of hospital admissions due to iatrogenic hypoglycemia in Alsace (France) over a year, to estimate the associated economic burden and to identify causes. Method A retrospective analysis was performed using data extracted from hospital databases. Costs were calculated from French official tariffs. Setting 31 public and private hospitals. A review of the medical records of patients with iatrogenic hypoglycemia-related hospital admissions was performed at the University Hospital of Strasbourg. Main outcome measures Hypoglycemia–related hospital admissions: number, costs and causes. Results Out of 42,381 hospitalizations, 147 iatrogenic hypoglycemia–related hospital admissions (0.4%) were identified; 41 patients with type 1 diabetes mellitus and 106 with type 2. The total cost associated to the 147 events was € 407,441. The median cost per patient was € 1,224.6 [563.0–2,505.7 (interquartile range)] for type 1 diabetes mellitus and € 3,670.9 [2,505.7–3,670.9] for type 2. Forty-six patients over the 147 were coming from the University Hospital of Strasbourg. In this hospital, the most common origin of the hypoglycemia was missed meals (n = 7), the second was a mismatch between antidiabetic medicines and carbohydrate intake (n = 6), the third was an incorrect use of antidiabetic medicines (n = 5). Conclusions 147 hospitalizations due to iatrogenic hypoglycemia were identified with an estimated global cost of € 407,441. Optimizing therapy with low-risk hypoglycemic medicines, improving access to continuous glucose monitoring systems and offering adequate education, could help address the causes of hypoglycemia.


France Hospital admission Iatrogenic hypoglycemia Inappropriate prescription Therapeutic education 



The authors wish to acknowledge Dr. Sylvie Fontanel and Daouda Camara from the ARS Grand Est (extraction of the data from regional PMSI database), Dr. Gabriel Nisand from the PMSI Department of the University Hospital of Strasbourg (access of the patients’ medical records) and Dr. Valérie Leray for proofreading and linguistic review of the manuscript.


This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Conflicts of interest

The authors report no conflict of interest relevant to the subject of this article.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of PharmacyUniversity Hospital of Strasbourg, NHC, Service de PharmacieStrasbourg CedexFrance
  2. 2.Faculty of PharmacyUniversity of StrasbourgStrasbourgFrance
  3. 3.Department of Internal MedicineUniversity Hospital of StrasbourgStrasbourgFrance
  4. 4.Department of Endocrinology and DiabetesUniversity Hospital of StrasbourgStrasbourgFrance
  5. 5.Laboratory of Neuro-cardiovascular Pharmacology and Toxicology EA7296University of StrasbourgStrasbourgFrance

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