Recurrent hospitalizations for severe hypoglycemia and hyperglycemia among U.S. adults with diabetes
Open accessAbstract
Aims Examine 30-day readmissions for recurrent hypoglycemia and hyperglycemia in a national cohort of adults with diabetes.Methods Retrospective analysis of data from OptumLabs Data Warehouse for all adults with diabetes hospitalized January 1, 2009 to December 31, 2014 with a principal diagnosis of hypoglycemia or hyperglycemia. We examined the rates and risk factors of 30-day readmissions for hypoglycemia and hyperglycemia.Results After 6419 index hypoglycemia hospitalizations, 1.2% were readmitted for recurrent hypoglycemia, 0.2% for hyperglycemia, and 8.6% for other causes. Multimorbidity was the strongest predictor of recurrent hypoglycemia. After 6872 index hyperglycemia hospitalizations, 4.0% were readmitted for recurrent hyperglycemia, 0.4% for hypoglycemia, and 5.4% for other causes. Recurrent hyperglycemia was less likely in older patients (OR 0.6, 95% CI 0.5-0.9 for 45-64 vs. <45 years) and with the addition of a new glucose-lowering medication at index discharge (OR 0.40; 95% CI 0.2-0.7). New hypoglycemia readmissions were most likely among patients ≥75 years (OR 13.3, 95% CI 2.4-73.4, vs. <45 years).Conclusions Patients hospitalized for hyperglycemia are often readmitted for recurrent hyperglycemia, while patients hospitalized for hypoglycemia are generally readmitted for unrelated causes. Early recognition of high risk patients may identify opportunities to improve post-discharge management and reduce these events.
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A substantial proportion of individuals hospitalized with DKA experience recurrent episodes.
“A substantial proportion of individuals hospitalized with DKA experience recurrent episodes (181,182), which underscores the importance of engaging individuals experiencing these events to identify triggers and prevent recurrence.”
From 6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes-2026. (2026) · cites this paper as [182]
The Results (section 3.1) show recurrent hyperglycemia after hospitalization for severe hyperglycemia, but the study groups ketoacidosis with hyperglycemic hyperosmolar state rather than reporting DKA recurrence separately. Recurrent hyperglycemia accounted for 41.3% of readmissions, not 41.3% of all patients hospitalized; the Abstract Results report a 4.0% 30-day readmission rate for recurrent hyperglycemia after index hyperglycemia hospitalizations. (LLM, conf=0.84)
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- Authors
- McCoy, R. G., Herrin, J., Lipska, K. J., & Shah, N. D.
- Affiliations
- Mayo Clinic (US)
- Yale University (US)
- Corresponding author
- McCoy, Rozalina G.
- Venue
- Journal of Diabetes and its Complications
- Publisher
- Elsevier BV
- Published
- 2018-07
- Volume
- 32
- Issue
- 7
- Pages
- 693-701
- ISSN
- 0891-6632 (ISSN-L)
- 1056-8727
- PMC
- PMC6015781
- OpenAlex
- W2800627095
- Cited by
- 40
- References
- 43
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 8 · 2023: 5 · 2022: 6 · 2021: 3 · 2020: 5 · 2019: 5
- FWCI
- 2.59
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Diabetes and its Complications (acceptedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute Of Diabetes And Digestive And Kidney Diseases
- National Institutes of Health
- National Institute on Aging (K23AG048359)
- CMS
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- recurrent hypoglycemia, hyperglycemia, diabetes mellitus, hospital readmission, 30-day readmission, multimorbidity, glucose-lowering medications, age differences, risk factors, post-discharge care
- MeSH terms
- Adult, Aged, Aged, 80 and over, Diabetes Mellitus, Female, Hospitalization, Humans, Hyperglycemia, Hypoglycemia, Male, Middle Aged, Patient Readmission, Recurrence, Retrospective Studies, Risk Factors, United States, Cohort Studies, Diabetic Ketoacidosis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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