RESEARCH OBJECTIVE: To investigate the impact of hypoglycemic events among hospitalized patients who have Type 2 Diabetes (T2D).
STUDY DESIGN: Retrospective analysis of data from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS). The NIS was queried for adult patients with T2D. Both T2D and hypoglycemic events were identified using International Classification of Diseases, 9th Edition-Clinical Modification (ICD-9-CM) diagnosis codes. Univariate statistical tests were used to compare characteristics of patients who did and did not have a hypoglycemic event; Student t-tests were used to compare continuous characteristics and chi-squared tests were used to compare binary and categorical characteristics. Multivariable analyses included logistic regression to predict hypoglycemic events and mortality, and generalized linear models (GLM) for total costs and length of stay.
POPULATION STUDIED: Adult inpatients in the NIS who had a primary diagnosis of T2D and an inpatient hospitalization between 2008-2013. Principal Findings: Among 5,665,276 T2D patients admitted for an inpatient stay, 0.09% of patients experienced a hypoglycemic event (N=4,992). Patients who were older, were admitted to a smaller hospital, had other types of insurance, were admitted for a non-elective stay, in an urban area, and had more comorbidities, were more likely to experience a hypoglycemic event during their inpatient stay. Patients who experienced a hypoglycemic event had a significantly greater mortality risk (OR=1.21; p<0.0001). They also had a significantly shorter length of stay (0.38; p<0.0001) and lower costs ($2,218; p<0.0001) compared to T2D patients who did not experience a hypoglycemic event.
CONCLUSIONS: Hypoglycemic events for T2D patients admitted for an inpatient stay were more likely to occur older individuals with numerous comorbidities and were admitted in a non-elective manner. Hypoglycemic events were significantly associated with increased mortality in T2D patients, in particular for the oldest patients, being almost 5 times more likely to die as the youngest. Hypoglycemic events were also associated with a shorter length of stay by almost 8 hours, and lower total costs by $2,218.
