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Cited by 46Diabetes Management and ResearchDiabetes Treatment and ManagementPatient Safety and Medication Errors

Increasing incidence of serious hypoglycemia in insulin users

JOHNSON, E, KOEPSELL, T, REIBER, G, STERGACHIS, A, PLATT, R·2002·Journal of Clinical Epidemiology
DOI 10.1016/s0895-4356(01)00479-6
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Abstract

Trials provide most of the data on the incidence of hypoglycemia in patients with diabetes. However, trial protocols may not reflect changes in diabetes management that occur over time. Using a retrospective cohort design, we calculated the incidence of hypoglycemia in 1,113 patients 20 to 64 years of age who used insulin monotherapy from 1993 through 1997 at Harvard Pilgrim Health Care, a health maintenance organization (HMO) in New England. Episodes included emergency department visits or hospital admissions for hypoglycemia identified through insurance claims and documented in patients' medical records. The incidence of hypoglycemia was 5.07 episodes per 100 person-years (95% CI, 4.14 to 6.00); 203 confirmed episodes occurred in 129 unique patients during 4,005 person-years of follow-up. The incidence increased by approximately 24% per year (rate ratio = 1.24; 95% CI, 1.11 to 1.38) from 1993 through 1997, perhaps reflecting physicians' and patients' efforts to intensify glucose management.

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Crossref · 10.1016/s0895-4356(01)00479-6

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19 of 19 references verified0 citation errors · 0 not checkable

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  • Johnson et al. limited their search to first-listed ICD-9-CM codes and excluded all other diagnosis fields.

    “First, Johnson et al. limited their search to first-listed ICD-9-CM codes and excluded all other diagnosis fields.”

    From Validation of ICD-9-CM coding algorithm for improved identification of hypoglycemia visits (2008) · cites this paper as [10]

  • Johnson et al. reported that ICD-9-CM code 250.8 identified over half of hypoglycemia episodes and had a PPV of 73% for their case definition.

    “Johnson, et al. first reported the utility of 250.8 in their strategy to identify ED visits for hypoglycemia [10]. In their analysis, this code also identified over half of hypoglycemia episodes and had a PPV of 73% for their case definition of hypoglycemia.”

    From Validation of ICD-9-CM coding algorithm for improved identification of hypoglycemia visits (2008) · cites this paper as [10]

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Authors
JOHNSON, E., KOEPSELL, T., REIBER, G., STERGACHIS, A., & PLATT, R.
Affiliations
  • University of Washington (US)
  • Brigham and Women's Hospital (US)
ORCID
Venue
Journal of Clinical Epidemiology
Publisher
Elsevier BV
Published
2002-03
Volume
55
Issue
3
Pages
253-259
ISSN
0895-4356 (ISSN-L)
DOI
10.1016/s0895-4356(01)00479-6
OpenAlex
W2086127783
Cited by
46
References
19
Citations by year
2026: 1 · 2025: 2 · 2023: 1 · 2022: 1 · 2020: 1 · 2016: 1 · 2015: 3 · 2014: 1 · 2013: 3 · 2012: 4
FWCI
1.90
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Clinical Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
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 › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
Keywords
hypoglycemia, insulin monotherapy, diabetes mellitus, hypoglycemia incidence, health maintenance organizations, emergency department visits, hospitalization, insurance claims
MeSH terms
Adult, Diabetes Mellitus, Female, Health Maintenance Organizations, Humans, Hypoglycemia, Insulin, Male, Middle Aged, Recurrence, Retrospective Studies, Risk Factors, Incidence, Poisson Distribution, Diabetes Complications

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