High rates of severe hypoglycemia among African American patients with diabetes: the surveillance, prevention, and Management of Diabetes Mellitus (SUPREME-DM) network

Karter, Andrew J; Lipska, Kasia J; O’Connor, Patrick J.; Liu, Jennifer Y.; Moffet, Howard H; Schroeder, Emily B.; Lawrence, Jean M.; Nichols, Gregory A.; Newton, Katherine M; Pathak, Ram D.; Desai, Jay; Waitzfelder, Beth; Butler, Melissa G.; Thomas, Abraham; Steiner, John F.

doi:10.1016/j.jdiacomp.2017.02.009

Cited by 53Diabetes Management and ResearchDiabetes Management and EducationDiabetes Treatment and Management

High rates of severe hypoglycemia among African American patients with diabetes: the surveillance, prevention, and Management of Diabetes Mellitus (SUPREME-DM) network

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Karter, Andrew J, Lipska, Kasia J, O’Connor, Patrick J., Liu, Jennifer Y., Moffet, Howard H, Schroeder, Emily B., Lawrence, Jean M., Nichols, Gregory A. +7 more·2017·Journal of Diabetes and its Complications

DOI 10.1016/j.jdiacomp.2017.02.009PMC PMC5491095

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Abstract

Aims Seven-year surveillance study (2005-2011) to evaluate race/ethnic differences in the trends in rates of severe hypoglycemia (SH) in a population of insured, at-risk adults with diabetes.Methods SH events were identified via any primary or principal diagnosis from emergency department or inpatient encounters among African American, Asian, Latino and White adult diabetes patients treated with insulin or secretagogues (Sulfonylureas or Meglitinides), receiving care from integrated healthcare delivery systems across the United States. We calculated age- and sex-standardized annual SH rates and average annual percent change (AAPC) in SH rates.Results Annual SH rates ranged from 1.8% to 2.1% during this 7-year observation period (2,200,471 person-years). African Americans had consistently higher SH rates compared with Whites, while Latinos and Asians had consistently lower rates compared with Whites in each of the 7 years (all p < 0.01). The trend increased significantly only among African Americans (AAPC = +4.3%; 95% CI: +2.1, +6.5%); in the other groups, the AAPC was not significantly different from zero.Conclusions Surveillance efforts should monitor the racial/ethnic-specific rates. The factors underlying substantially higher rates of hypoglycemia in African Americans should be evaluated. Clinically and culturally-appropriate strategies to reduce the risk of SH need to be developed and tested.

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African American individuals are at substantially increased risk of level 3 hypoglycemia.
“African American individuals are at substantially increased risk of level 3 hypoglycemia (88,89).”
From 6. Glycemic Targets: Standards of Care in Diabetes—2023 (2023) · cites this paper as [89]

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Authors: Karter, A. J., Lipska, K. J., O’Connor, P. J., Liu, J. Y., Moffet, H. H., Schroeder, E. B., Lawrence, J. M., Nichols, G. A., Newton, K. M., Pathak, R. D., Desai, J., Waitzfelder, B., Butler, M. G., Thomas, A., & Steiner, J. F.
Affiliations: Kaiser Permanente (US)
Yale University (US)
HealthPartners (US)
Kaiser Permanente Center for Health Research (US)
Kaiser Permanente Washington Health Research Institute (US)
Marshfield Clinic (US)
Lutheran Medical Center (US)
Corresponding author: Karter, Andrew J
ORCID: Karter, Andrew J
Lipska, Kasia J
O’Connor, Patrick J.
Liu, Jennifer Y.
Moffet, Howard H
Schroeder, Emily B.
Lawrence, Jean M.
Nichols, Gregory A.
Newton, Katherine M
Desai, Jay
Waitzfelder, Beth
Butler, Melissa G.
Thomas, Abraham
Steiner, John F.
Venue: Journal of Diabetes and its Complications
Publisher: Elsevier BV
Published: 2017-05
Volume: 31
Issue: 5
Pages: 869-873
ISSN: 0891-6632 (ISSN-L)
1056-8727
DOI: 10.1016/j.jdiacomp.2017.02.009
PMC: PMC5491095
OpenAlex: W2591385393
Cited by: 53
References: 47
Citations by year: 2026: 1 · 2025: 4 · 2024: 3 · 2023: 6 · 2022: 7 · 2021: 8 · 2020: 6 · 2019: 10 · 2018: 6 · 2017: 2
FWCI: 5.18
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Diabetes and its Complications (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: Henry Ford Health System
Washington State University
National Institutes of Health (UL1TR001863)
Agency for Healthcare Research and Quality (R01HS019859)
National Institute on Aging (K23AG048359)
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK103721, R01DK081796, P30DK092924)
National Center for Advancing Translational Sciences
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords: severe hypoglycemia, African American patients, racial and ethnic disparities, diabetes mellitus, insulin therapy, sulfonylureas, meglitinides, integrated health system
MeSH terms: Adolescent, Adult, Age Factors, Black or African American, Combined Modality Therapy, Diabetes Mellitus, Female, Humans, Hypoglycemia, Male, Managed Care Programs, Middle Aged, Population Surveillance, Retrospective Studies, Risk Factors, Severity of Illness Index, Sex Factors, United States, Cohort Studies, Delivery of Health Care, Integrated, Health Status Disparities, Young Adult

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High rates of severe hypoglycemia among African American patients with diabetes: the surveillance, prevention, and Management of Diabetes Mellitus (SUPREME-DM) network

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