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Hypoglycemia and Medical Expenses in Patients with Type 2 Diabetes Mellitus: An Analysis Based on the Korea National Diabetes Program Cohort.

ABSTRACT: BACKGROUND AND AIMS:Hypoglycemia is one of the most important adverse events in individuals with type 2 diabetes mellitus (T2DM). However, hypoglycemia-related events are usually overlooked and have been documented less in clinical practice. MATERIALS AND METHODS:We evaluated the incidence, clinical characteristics, and medical expenses of hypoglycemia related events in T2DM patients based on the Korea National Diabetes Program (KNDP), which is the largest multi-center, prospective cohort in Korea (n = 4,350). For accurate outcomes, the KNDP data were merged with claims data from the Health Insurance Review and Assessment Service (HIRA) of Korea. RESULTS:During a median follow-up period of 3.23 years (95% CI: 3.14, 3.19), 88 subjects (2.02%) were newly diagnosed with hypoglycemia, and the incidence of hypoglycemia was 6.44 cases per 1,000 person-years (PY). Individuals with hypoglycemia were significantly older (59.7±10.7 vs. 53.3±10.4 years, p < 0.001), had more hospital visits (121.94±126.88 days/PY, p < 0.001), had a longer hospital stays (16.13±29.21 days/PY, p < 0.001), and incurred greater medical costs ($2,447.56±4,056.38 vs. $1,336.37±3,403.39 /PY, p < 0.001) than subjects without hypoglycemia. CONCLUSION:Hypoglycemia-related events were infrequently identified among the medical records of T2DM subjects. However, they were associated significantly with poor clinical outcomes, and thus, hypoglycemia could have a substantial burden on the Korean national healthcare system.

SUBMITTER: Rhee SY

PROVIDER: S-EPMC4758656 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Hypoglycemia and Medical Expenses in Patients with Type 2 Diabetes Mellitus: An Analysis Based on the Korea National Diabetes Program Cohort.

Rhee Sang Youl SY Hong Soo Min SM Chon Suk S Ahn Kyu Jeung KJ Kim Sung Hoon SH Baik Sei Hyun SH Park Yong Soo YS Nam Moon Suk MS Lee Kwan Woo KW Woo Jeong-Taek JT Kim Young Seol YS

PloS one 20160218 2

<h4>Background and aims</h4>Hypoglycemia is one of the most important adverse events in individuals with type 2 diabetes mellitus (T2DM). However, hypoglycemia-related events are usually overlooked and have been documented less in clinical practice.<h4>Materials and methods</h4>We evaluated the incidence, clinical characteristics, and medical expenses of hypoglycemia related events in T2DM patients based on the Korea National Diabetes Program (KNDP), which is the largest multi-center, prospectiv ...[more]

PMID: 26890789

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Project description:Diabetes mellitus (DM) is a significant chronic disease, and health burden from DM is increasing. Recently, studies on the relationship between handgrip strength, which is a measuring tool for muscle strength, and type 2 DM were published. However, the results have been conflicting. In addition, few studies that used data from adults in Korea have been conducted. Thus, this study aimed to identify the association between handgrip strength as well as type 2 DM and insulin resistance in adults using data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2014 to 2015. Inflammation is a condition affecting the muscle strength of individuals with type 2 DM; therefore, its mediating effects were also examined.We included 8208 participants aged between 19 and 80 years who had undergone a handgrip test and had received information about type 2 DM. General linear and binary logistic regression models were used to examine the association between handgrip strength and type 2 DM variables. In addition, mediation analysis was conducted to estimate the role of inflammation in the relationship between handgrip strength and type 2 DM.After adjusting for age, sex, education, alcohol consumption, lifetime smoking, obesity, and aerobic physical activity, handgrip strength was inversely associated with fasting glucose, HbA1c, and fasting insulin levels as well as the homeostasis model assessment of insulin resistance (HOMA-IR) score. Multivariable logistic regression analyses showed that handgrip strength was significantly inversely associated with type 2 DM and insulin resistance. The high-sensitivity C-reactive protein (hs-CRP), an inflammation-related biomarker, mediated approximately 10% of the association between handgrip strength and type 2 DM.Using large, well-defined, nationally representative cross-sectional data on adults in Korea, we found that handgrip strength, which is an indicator of muscle strength, was associated with type 2 DM.

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Hypoglycemia and Medical Expenses in Patients with Type 2 Diabetes Mellitus: An Analysis Based on the Korea National Diabetes Program Cohort.

Publications

Hypoglycemia and Medical Expenses in Patients with Type 2 Diabetes Mellitus: An Analysis Based on the Korea National Diabetes Program Cohort.

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