Risk factors and outcome differences in hypoglycaemia‐related hospital admissions: A case‐control study in E ngland
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Aims: To evaluate risk factors for hospital admissions for hypoglycaemia and compare length of hospitalization, inpatient mortality and hospital readmission between hypoglycaemia‐ and non‐hypoglycaemia‐related admissions. Materials and methods: We used all admissions for hypoglycaemia in individuals with diabetes to English NHS hospital trusts between 2005 and 2014 (101 475 case admissions) and 3 random admissions per case in individuals with diabetes without hypoglycaemia (304 425 control admissions). Risk factors and differences in the 3 outcomes were estimated with logistic and negative binomial regressions. Results: A U‐shaped relationship between age and risk of admission for hypoglycaemia was observed until the age of 85 years; compared to the nadir at 60 years, the risk was progressively higher in younger and older patients and steadily declined after 85 years. Social deprivation (positively) and comorbidities (negatively) were associated with the risk of admission for hypoglycaemia. Compared to C aucasians, other ethnic groups had lower ( B angladeshi, P akistani, I ndians) or higher ( C aribbean) risk of admission for hypoglycaemia. Length of hospitalization was 26% shorter while risk of rehospitalization was 65% higher in individuals admitted for hypoglycaemia. Compared to admissions for hypoglycaemia, risk of inpatient mortality was 50% lower for unstable angina but higher for acute myocardial infarction (3 times), acute renal failure (5 times) or pneumonia (8 times). Conclusions: Among hospital‐admitted individuals with diabetes, age, social deprivation, comorbidities and ethnicity are associated with higher frequency of hospitalization for hypoglycaemia. Admission for hypoglycaemia is associated with a greater risk of readmission, a shorter length of hospitalisation and a generally lower inpatient mortality compared to admissions for other medical conditions. These results could help in identifying at‐risk groups to reduce the burden of hospitalization for hypoglycaemia.
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Some factors associated with early hypoglycaemia, such as prior hypoglycaemia, have been associated with hypoglycaemia risk in previous studies.
“Some of these factors, such as prior hypoglycaemia, have been associated with hypoglycaemia risk in previous studies.26,27”
From Early hypoglycaemia and adherence after basal insulin initiation in a nationally representative sample of Medicare beneficiaries with type 2 diabetes (2019) · cites this paper as [27]
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References 31 · Cited by 15
- Authors
- Zaccardi, F., Webb, D. R., Davies, M. J., Dhalwani, N. N., Housley, G., Shaw, D., Hatton, J. W., & Khunti, K.
- Affiliations
- University of Leicester (GB)
- East Midlands Academic Health Science Network (GB)
- Nottingham University Hospitals and East Midlands Academic Health Science Network Nottingham England
- Corresponding author
- Zaccardi, Francesco
- ORCID
- Venue
- Diabetes, Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2017-04-21
- Volume
- 19
- Issue
- 10
- Pages
- 1371-1378
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- OpenAlex
- W2597949196
- Cited by
- 15
- References
- 31
- Citations by year
- 2024: 1 · 2022: 1 · 2021: 1 · 2020: 4 · 2019: 2 · 2018: 3 · 2017: 3
- FWCI
- 2.59
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Locations
- Diabetes Obesity and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Nottingham ePrints (University of Nottingham) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Leicester Research Archive (University of Leicester) (submittedVersion)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- Funders
- Clinical Research Fellow
- Sanofi-Aventis
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care-East Midlands (NIHR CLAHRC-M)
- Leicester Clinical Trials Unit
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit
- 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, diabetes mellitus, hospitalization, risk factors, length of hospital stay, in-hospital mortality, hospital readmission, social deprivation, comorbidities, ethnicity, age, acute myocardial infarction, acute kidney injury, pneumonia, unstable angina
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Diabetes Mellitus, England, Female, Hospitalization, Humans, Hypoglycemia, Hypoglycemic Agents, Male, Middle Aged, Prognosis, Retrospective Studies, Risk Factors, Case-Control Studies, Young Adult
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