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Frequency of Severe Hypoglycemia Requiring Emergency Treatment in Type 1 and Type 2 Diabetes

Leese, Graham P., Wang, Jixian, Broomhall, Janice, Kelly, Paul, Marsden, Andrew, Morrison, William, Frier, Brian M., Morris, Andrew D., For the DARTS/MEMO Collaboration·2003·Diabetes Care

DOI 10.2337/diacare.26.4.1176

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Abstract

OBJECTIVE—To determine the incidence, predisposing factors, and costs of emergency treatment of severe hypoglycemia in people with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS—Over a 12-month period, routinely collected datasets were analyzed in a population of 367,051 people, including 8,655 people with diabetes, to measure the incidence of severe hypoglycemia that required emergency assistance from Ninewells Hospital and Medical School (NHS) personnel including those in primary care, ambulance services, hospital accident and emergency departments, and inpatient care. Associated costs with these episodes were calculated. RESULTS—A total of 244 episodes of severe hypoglycemia were recorded in 160 patients, comprising 69 (7.1%) people with type 1 diabetes, 66 (7.3%) with type 2 diabetes treated with insulin, and 23 (0.8%) with type 2 diabetes treated with sulfonylurea tablets. Incidence rates were 11.5 and 11.8 events per 100 patient-years for type 1 and type 2 patients treated with insulin, respectively. Age, duration, and socioeconomic status were identified as risk factors for severe hypoglycemia. One in three cases were treated solely by the ambulance service with no other contact from health care professionals. The total estimated cost of emergency treatment of severe hypoglycemia was ≤£92,078 in one year. CONCLUSIONS—Hypoglycemia requiring emergency assistance from health service personnel is as common in people with type 2 diabetes treated with insulin as in people with type 1 diabetes. It is associated with considerable NHS resource use that has a significant economic and personal cost.

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Authors: Leese, G. P., Wang, J., Broomhall, J., Kelly, P., Marsden, A., Morrison, W., Frier, B. M., Morris, A. D., & For the DARTS/MEMO Collaboration
Affiliations: Ninewells Hospital (GB)
Scottish Ambulance Service, Tayside Division, Dundee, U.K.
Edinburgh Royal Infirmary (GB)
ORCID: Leese, Graham P.
Wang, Jixian
Morrison, William
Frier, Brian M.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2003-04-01
Volume: 26
Issue: 4
Pages: 1176-1180
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/diacare.26.4.1176
OpenAlex: W2107648636
Cited by: 559
References: 25
Citations by year: 2026: 3 · 2025: 6 · 2024: 11 · 2023: 10 · 2022: 9 · 2021: 18 · 2020: 21 · 2019: 25 · 2018: 25 · 2017: 35 · 2016: 43 · 2015: 60 · 2014: 38 · 2013: 35 · 2012: 37
FWCI: 10.97
Type: journal article
Language: en
Open access: closed
Locations: Diabetes Care (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 › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
Keywords: severe hypoglycemia, type 1 diabetes, type 2 diabetes, insulin therapy, emergency treatment, ambulance services, incidence, risk factors, socioeconomic status, health care costs, NHS resource use
MeSH terms: Adult, Aged, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Emergencies, Glycated Hemoglobin, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Middle Aged, Scotland, Body Mass Index, Incidence

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Frequency of Severe Hypoglycemia Requiring Emergency Treatment in Type 1 and Type 2 Diabetes

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