Severe hypoglycaemia in adults with insulin-treated diabetes: impact on healthcare resources

AimsTo assess resource utilization associated with severe hypoglycaemia across three insulin regimens in a large phase3a clinical programme involving people with Type1 diabetes treated with basal-bolus insulin, people with Type2 diabetes treated with multiple daily injections and people with Type2 diabetes treated with basal-oral therapy. MethodsData relating to severe hypoglycaemia events (defined as episodes requiring external assistance) from the insulin degludec and insulin degludec/insulin aspart programme (15 trials) were analysed using descriptive statistics. Comparators included insulin glargine, biphasic insulin aspart, insulin detemir and sitagliptin. Mealtime insulin aspart was used in some regimens. This analysis used the serious adverse events records, which documented the use of ambulance/emergency teams, a hospital/emergency room visit 24h, or a hospital visit >24h. ResultsIn total, 536 severe hypoglycaemia events were analysed, of which 157 (29.3%) involved an ambulance/emergency team, 64 (11.9%) led to hospital/emergency room attendance of 24h and 36 (6.7%) required hospital admission (>24h). Although there were fewer events in people with Type2 diabetes compared with Type1 diabetes, once a severe episode occurred, the tendency to utilize healthcare resources was higher in Type2 diabetes vs. Type1 diabetes. A higher proportion (47.6%) in the basal-oral therapy group required hospital treatment for >24h versus the Type1 diabetes (5.0%) and Type2 diabetes multiple daily injections (5.3%) groups. ConclusionThis analysis suggests that severe hypoglycaemia events often result in emergency/ambulance calls and hospital treatment, incurring a substantial health economic burden, and were associated with all insulin regimens.