The DOI matches its Crossref record; 25 of the 25 references it cites were found in a registry or an index.
Frequency of Severe Hypoglycemia Requiring Emergency Treatment in Type 1 and Type 2 Diabetes
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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Severe hypoglycemia had re-quired emergency treatment in 7.1% of patients with type 1 diabetes, in 7.3% of patients with insulin-treated type 2 diabetes, and in 0.8% of patients taking oral antidiabetic agents.”
From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [79]
In the citing paper
“The frequency of hypoglycemia is lower in people treated with sulfonylureas than in those treated with insulin (2,76,79) but is probably underestimated (104).”
From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [79]
Citations
Cites
Role of Insulin Resistance in Human Disease
Reaven, G. M. (1988) · Diabetes · doi:10.2337/diab.37.12.1595 · Cited by 12,154
Banting lecture 1988. Role of insulin resistance in human disease.
Reaven, G. (1988) · Diabetes · doi:10.2337/diabetes.37.12.1595 · Cited by 3,801
Deprivation and Health in Scotland
Tunstall-Pedoe, H. (1993) · Postgraduate Medical Journal · doi:10.1136/pgmj.69.814.665-a · Cited by 1,171
Gold, A. E., Macleod, K. M., & Frier, B. M. (1994) · Diabetes Care · doi:10.2337/diacare.17.7.697 · Cited by 810
Self-citationEpidemiology of severe hypoglycemia in the diabetes control and complications trial
(1991) · The American Journal of Medicine · doi:10.1016/0002-9343(91)80085-z · Cited by 807
Hypoglycemia in the Diabetes Control and Complications Trial
The Diabetes Control and Complications Trial Research Group (1997) · Diabetes · doi:10.2337/diab.46.2.271 · Cited by 746
Abraira, C., Colwell, J. A., Nuttall, F. Q., Sawin, C. T., Nagel, N. J., Comstock, J. P., Emanuele, N. V., Levin, S. R., Henderson, W., Lee, H. S., et al. (1995) · Diabetes Care · doi:10.2337/diacare.18.8.1113 · Cited by 355
Microvascular and acute complications in IDDM patients: the EURODIAB IDDM Complications Study
Stephenson, J., Fuller, J., & EUROBIAB IDDM Complications Study Group (1994) · Diabetologia · doi:10.1007/bf00398055 · Cited by 345
Hypoglycemia in patients with type 2 diabetes mellitus
Miller, C. D., Phillips, L. S., Ziemer, D. C., Gallina, D. L., Cook, C. B., & El-Kebbi, I. M. (2001) · Archives of Internal Medicine · doi:10.1001/archinte.161.13.1653 · Cited by 341
Symptomatic Hypoglycaemia in 411 Type 1 Diabetic Patients
Pramming, S., Thorsteinsson, B., Bendtson, I., & Binder, C. (1991) · Diabetic Medicine · doi:10.1111/j.1464-5491.1991.tb01575.x · Cited by 336
Morris, A. D., Boyle, D. I., MacAlpine, R., Emslie-Smith, A. M., Jung, R. T., Newton, R. W., & MacDonald, T. M. (1997) · BMJ · doi:10.1136/bmj.315.7107.524 · Cited by 297
Self-citationFrequency and Morbidity of Severe Hypoglycaemia in Insulin‐treated Diabetic Patients
MacLeod, K. M., Hepburn, D. A., & Frier, B. M. (1993) · Diabetic Medicine · doi:10.1111/j.1464-5491.1993.tb00051.x · Cited by 252
Self-citationIntensified insulin therapy and the risk of severe hypoglycaemia
Bott, S., Bott, U., Berger, M., & Mühlhauser, I. (1997) · Diabetologia · doi:10.1007/s001250050769 · Cited by 180
Clinical characteristics of type 1 diabetic patients with and without severe hypoglycemia.
ter Braak, E. W. M. T., Appelman, A. M. M. F., van der Laak, M. F., Stolk, R. P., van Haeften, T. W., & Erkelens, D. W. (2000) · Diabetes Care · doi:10.2337/diacare.23.10.1467 · Cited by 163
Hepburn, D. A., MacLeod, K. M., Pell, A. C. H., Scougal, I. J., & Frier, B. M. (1993) · Diabetic Medicine · doi:10.1111/j.1464-5491.1993.tb00050.x · Cited by 154
Self-citationInsulin-induced hypoglycaemia in an accident and emergency department: the tip of an iceberg?
Potter, J., Clarke, P., Gale, E. A. M., Dave, S. H., & Tattersall, R. B. (1982) · BMJ · doi:10.1136/bmj.285.6349.1180 · Cited by 120
The cost-effectiveness of different management strategies for Type I diabetes: a Swiss perspective
Palmer, A. J., Weiss, C., Sendi, P., Neeser, K., Brandt, A., Singh, G., Wenzel, H., & Spinas, G. A. (2000) · Diabetologia · doi:10.1007/s001250050003 · Cited by 115
The Tayside Medicines Monitoring Unit (MEMO)
Wei, L., Parkinson, J., & MacDonald, T. M. (2006) · Pharmacoepidemiology · doi:10.1002/9780470059876.ch21 · Cited by 68
Larsson, H. E., & Åhrén, B. (2000) · Diabetologia · doi:10.1007/s001250050029 · Cited by 65
Frequency of severe hypoglycaemia in type 1 and type 2 diabetes during conventional insulin therapy
Gürlek, A., Erbas, T. A., & Gedik, O. (2009) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-0029-1212102 · Cited by 32
The Tayside Medicines Monitoring Unit (MEMO)
Evans, J. M. M., & MacDonald, T. M. (2000) · Pharmacoepidemiology · doi:10.1002/0470842555.ch22 · Cited by 24
Hypoglycaemia in the diabetic adult
Frier, B. M. (1993) · Baillière s Clinical Endocrinology and Metabolism · doi:10.1016/s0950-351x(05)80218-6 · Cited by 21
Self-citationAmbulance visits for severe hypoglycaemia in insulin-treated diabetes.
Daniels, A., White, M., Stander, I. A., & Crone, D. (1999) · PubMed · Cited by 16
Flagged first, then by citations
Cited by
Sorted by citations
Clinical Practice Guidelines for Multiple Endocrine Neoplasia Type 1 (MEN1)
Thakker, R. V., Newey, P. J., Walls, G. V., Bilezikian, J. P., Dralle, H., Ebeling, P. R., Melmed, S. K., Sakurai, A., Tonelli, F., & Brandi, M. L. (2012) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2012-1230 · Cited by 1,500
Cryer, P. E., Axelrod, L., Grossman, A. B., Heller, S. R., Montori, V. M., Seaquist, E. R., & Service, F. J. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2008-1410 · Cited by 1,277
Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer
Francis, G. L., Waguespack, S. G., Bauer, A. J., Angelos, P., Benvenga, S., Cerutti, J. M., Dinauer, C., Hamilton, J. K., HAY, I. D., Luster, M., et al. (2015) · Thyroid · doi:10.1089/thy.2014.0460 · Cited by 1,273
Cryer, P. E., Davis, S. N., & Shamoon, H. (2003) · Diabetes Care · doi:10.2337/diacare.26.6.1902 · Cited by 1,160
Defining and Reporting Hypoglycemia in Diabetes
American Diabetes Association Workgroup on Hypoglycemia (2005) · Diabetes Care · doi:10.2337/diacare.28.5.1245 · Cited by 1,146
Metadata
- 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)
- 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
- 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
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 ›
Are you an author, or do you see a problem with this page? Request a review
