Glucagon prescription patterns in patients with either type 1 or 2 diabetes with newly prescribed insulin

Mitchell, Beth D.; He, Xuanyao; Sturdy, Ian M.; Cagle, Andrew P.; Settles, Julie A.

doi:10.4158/ep15831.or

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

Glucagon prescription patterns in patients with either type 1 or 2 diabetes with newly prescribed insulin

Mitchell, Beth D., He, Xuanyao, Sturdy, Ian M., Cagle, Andrew P., Settles, Julie A.·2016·Endocrine Practice

DOI 10.4158/ep15831.or

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Abstract

Objective To describe glucagon prescription patterns in patients with type 1 (T1DM) or type 2 diabetes (T2DM) who received an initial insulin prescription.Methods Retrospective analyses were conducted with data from Truven Health MarketScan databases to assess time to glucagon prescriptions: filled within 1.5 months after index date (early) or after 1.5 months postindex (nonearly). The index date was the date of first insulin prescription between January 1, 2009 and December 31, 2011; for T2DM, without an insulin prescription in the previous 6 months; for T1DM, diabetes diagnosis preindex or within 3 months postindex.Results Analysis included 8,814 patients with T1DM and 47,051 with T2DM (49.3% and 2.4%, respectively) who had glucagon prescriptions filled. The median times to first glucagon prescription were 196 days (T1DM) and 288 days (T2DM). The rates of filling glucagon were highest in the first 1.5 months. The times to first hypoglycemia-related emergency room (ER) visit for T1DM and T2DM cohorts were initially similar for those with early glucagon versus nonearly glucagon prescriptions. After 10.8 and 2.5 months postindex, respectively, the percentage of hypoglycemia-related ER visits was lower for those with early glucagon prescriptions.Conclusion Glucagon prescriptions filled for patients with diabetes who are initiating insulin are low. Patients with T1DM who were younger and healthier filled glucagon prescriptions more often; patients with T2DM who were younger and sicker and had a higher percentage of hypoglycemia-related ER visit history filled glucagon prescriptions more often. Glucagon filled early was associated with a lower incidence of hypoglycemia-related ER visits.

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Individuals with one or more episodes of clinically significant hypoglycemia may benefit from at least short-term relaxation of glycemic targets and availability of glucagon.
“Hence, individuals with one or more episodes of clinically significant hypoglycemia may benefit from at least short-term relaxation of glycemic targets and availability of glucagon (107).”
From 6. Glycemic Targets: Standards of Care in Diabetes—2023 (2023) · cites this paper as [107]

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379-P: Glucagon Use by U.S. Adults with Type 1 and Type 2 Diabetes
Kahn, P. A., LIU, S., McCoy, R. G., Gabbay, R. A., & Lipska, K. J. (2020) · Diabetes · doi:10.2337/db20-379-p
Glucagon prescribing and prevention of hospitalization for hypoglycemia in a large health system
Herges, J. R., Haag, J. D., Tarpenning, K. A. K., Mara, K. C., & McCoy, R. G. (2023) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2023.110832 · Cited by 3 · see citing works

Authors: Mitchell, B. D., He, X., Sturdy, I. M., Cagle, A. P., & Settles, J. A.
Affiliations: Eli Lilly (United States) (US)
Corresponding author: Mitchell, Beth D.
ORCID: Mitchell, Beth D.
Venue: Endocrine Practice
Publisher: Elsevier BV
Published: 2016-02
Volume: 22
Issue: 2
Pages: 123-135
ISSN: 1530-891X (ISSN-L)
DOI: 10.4158/ep15831.or
OpenAlex: W1802476941
Cited by: 46
References: 38
Citations by year: 2025: 1 · 2023: 9 · 2022: 10 · 2021: 7 · 2020: 12 · 2019: 5 · 2017: 1 · 2016: 1
FWCI: 0.58
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Endocrine Practice (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: glucagon, prescribing patterns, type 1 diabetes, type 2 diabetes, insulin initiation, hypoglycemia, emergency department visits
MeSH terms: Adolescent, Adult, Aged, Aged, 80 and over, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Glucagon, Humans, Hypoglycemic Agents, Insulin, Male, Middle Aged, Practice Patterns, Physicians', Retrospective Studies, Young Adult

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Glucagon prescription patterns in patients with either type 1 or 2 diabetes with newly prescribed insulin

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