Increase in hypoglycemic admissions: California hospital discharge data.
ABSTRACT To compare the percentage of diabetics admitted to the hospital due to hypoglycemia in 1990-1993 (period 1) to that in 1997-2000 (period 2).
We analyzed data from the California Hospital Discharge Data Program. Eligibility included diabetic (ICD code 250) subjects aged > or =25 years old who were hospitalized due to hypoglycemia (ICD Codes 250.8) during the periods 1990-1993 and 1997-2000. Data were analyzed by demographics and health insurance status.
Of the 2,905,091 hospitalized diabetics, 50,017 (1.7%) were due to hypoglycemia. The percentage of hospitalization due to hypoglycemic varied by sex, age, race/ethnicity, and insurance status (P = .0001). Male, Hispanic, age 25-64 years, with Medical/Medicare insurance had higher odds of being hospitalized due to hypoglycemia relative to other groups (P < .001). The percentage of diabetics hospitalized due to hypoglycemia increased from period 1 to period 2 (1.3% vs. 2.0%, P = .0001). Diabetics hospitalized in period 2 had higher adjusted odds of being hospitalized due to hypoglycemia relative to those admitted in period 1 (OR = 1.6, P < .0001).
Our data show an increase in the hospitalization due to hypoglycemia in diabetic patients. Enhanced patient education about self-monitoring of blood sugar and recognizing and treating the symptoms of hypoglycemia may help to minimize hypoglycemic hospitalizations.
Full-textDOI: · Available from: Senait Teklehaimanot, May 29, 2015
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ABSTRACT: The 2014 National Action Plan for Adverse Drug Event Prevention has recognized adverse drug events (ADEs) as a national priority in order to facilitate a nationwide reduction in patient harms from these events. Throughout this effort, it will be integral to identify populations that may be at particular risk in order to improve care for these patients. We have undertaken a systematic review to evaluate the evidence regarding racial or ethnic disparities in ADEs with particular emphasis on anticoagulants, diabetes agents, and opioids due to the clinical significance and preventability of ADEs associated with these medication classes. From an initial search yielding 3302 studies, we identified 40 eligible studies. Twenty-seven of these included studies demonstrated the presence of a racial or ethnic disparity. There was not consistent evidence for racial or ethnic disparities in the eight studies of ADEs in general. Asians were most frequently determined to be at higher risk of anticoagulant-related ADEs and Black patients were most frequently determined to be at higher risk for diabetes agents-related ADEs. Whites were most frequently identified as at increased risk for opioid-related ADEs. However, few of these studies were specifically designed to evaluate racial or ethnic disparities, lacking a standardized approach to racial/ethnic categorization as well as control for potential confounders. We suggest the need for targeted interventions to reduce ADEs in populations that may be at increased risk, and we suggest strategies for future research.
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ABSTRACT: To investigate the rates and risk of hospitalisations in patients with type 2 diabetes (T2D) mellitus in England. This retrospective population-based cohort study used computerised records from the General Practice Research Database linked to Hospital Episode Statistics data in England. Patients with T2D from January 2006 to December 2010 were selected. Primary outcome measures were all-cause, non-diabetes-related, diabetes-related and hypoglycaemia-related hospitalisations. Factors associated with all-cause and diabetes-related hospitalisations were investigated with Cox's proportional hazards models. Amongst 97,689 patients with T2D, approximately 60% had at least one hospitalisation during the 4-year study period. Rates of hospitalisation were as follows: all-cause, 33.9 per 100 patient-years (pt-yrs); non-diabetes-related, 29.1 per 100 pt-yrs; diabetes-related, 18.8 per 100 pt-yrs and hypoglycaemia, 0.3 per 100 pt-yrs. The risk of all-cause hospitalisation increased with hospitalisation in the previous year, insulin use and the presence of major comorbidities. The risk of a diabetes-related hospitalisation increased with age, female gender, insulin use, chronic renal insufficiency, hypoglycaemia (as diagnosed by a general practitioner) and diabetes-related hospitalisation in the previous year. Patients with T2D are hospitalised at a considerably high rate for causes directly related with diabetes complications and stay longer in hospital. History of hospitalisation and complications of diabetes were found to be predictive of inpatient hospitalisations suggesting previous hospitalisation episodes could serve as points of intervention. This study highlights important areas for healthcare intervention and provides a reminder for vigilance when risk factors for hospitalisation in patients with T2D are present.International Journal of Clinical Practice 09/2013; 68(1). DOI:10.1111/ijcp.12265 · 2.54 Impact Factor