More Hospitalized for Low Blood Sugar Than High

Diabetes patients more likely to face emergencies due to hypoglycemia than hyperglycemia

(RxWiki News) Over the past decade, as diabetes management has improved, fewer have been hospitalized for high blood sugar. Hospitalization rates for low blood sugar, on the other hand, have risen.

As a recent report from the Centers for Disease Control and Prevention (CDC) showed, diabetes patients face lower rates of hyperglycemia (high blood sugar), heart attack and stroke than they did 10 years ago.

A new study has found, however, that increasing efforts to prevent high blood sugar may have come with a price — boosting severe cases of hypoglycemia (low blood sugar).

"Be aware of the danger of low blood sugar when treating diabetes."

Kasia J. Lipska, MD, an instructor of endocrinology at the Yale School of Medicine in New Haven, Connecticut, and her colleagues sifted through data on almost 34 million individuals who received Medicare benefits between 1999 and 2011 looking for information on diabetes patients who were hospitalized during those 12 years.

They found that a total 279,937 people had 302,095 hospitalizations for hyperglycemia, and 404,467 patients had 429,850 hospitalizations for hypoglycemia.

The investigators calculated that the rate of admissions for hyperglycemia dropped by 38.6 percent over those 12 years, while the rate for admissions for hypoglycemia climbed by 11.7 percent.

Dr. Lipska and her team noted that black patients experienced much higher rates of hospitalizations (four times greater) for both hyperglycemia and hypoglycemia compared to white patients.

Also, older adults age 75 and up had a hospitalization rate for hypoglycemia that was two times greater than for those who were age 65 to 74.

The researchers added that both hyperglycemic and hypoglycemic patients had similar mortality (death) rates at the 30-day and one-year mark, and they had similar rates for 30-day hospital readmission.

“Although admission rates for hypoglycemia have declined modestly since 2007, efforts to further reduce these hospitalizations, especially among black and older adults, are urgently needed,” concluded the authors. “Evaluations of DM [diabetes mellitus] care quality based on achieved glycemic targets do not account for adverse consequences of treatment, such as hypoglycemia. Studies that consider these important patient outcomes will provide a more comprehensive assessment of the overall quality of DM treatment.”

The study was published May 17 in JAMA Internal Medicine. Research was made possible by a grant from from the National Center for Advancing Translational Science (NCATS), a component of the National Institutes of Health. Collaborating researchers reported receiving support from Medtronic through Yale University and CMS. One participating doctor served as an advisor to Merck, Boehringer Ingelheim, BMS, Janssen and Novo-Nordisk, and another chairs a cardiac scientific advisory board for UnitedHealth.

Review Date: 
May 18, 2014