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