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- Title
National Trends in US Hospital Admissions for Hyperglycemia and Hypoglycemia Among Medicare Beneficiaries, 1999 to 2011.
- Authors
Lipska, Kasia J.; Ross, Joseph S.; Yun Wang; Inzucchi, Silvio E.; Minges, Karl; Karter, Andrew J.; Huang, Elbert S.; Desai, Mayur M.; Gill, Thomas M.; Krumholz, Harlan M.
- Abstract
OBJECTIVE: To characterize changes in hyperglycemia and hypoglycemia hospitalization rates and subsequent mortality and readmission rates among older adults in the United States over a 12-year period, and to compare these results according to age, sex, and race. MAIN OUTCOMES AND MEASURES: Hospitalization rates for hyperglycemia and hypoglycemia, 30-day and 1-year mortality rates, and 30-day readmission rates RESULTS: A total of 279 937 patients experienced 302 095 hospitalizations for hyperglycemia, and 404 467 patients experienced 429 850 hospitalizations for hypoglycemia between 1999 and 2011. During this time, rates of admissions for hyperglycemia declined by 38.6% (from 114 to 70 admissions per 100 000 person-years), while admissions for hypoglycemia increased by 11.7% (from 94 to 105 admissions per 100 000 person-years). In analyses designed to account for changing diabetes mellitus prevalence, admissions for hyperglycemia and hypoglycemia declined by 55.2% and 9.5%, respectively. Trends were similar across age, sex, and racial subgroups, but hypoglycemia rates were 2-fold higher for older patients (≥ 75 years) when compared with younger patients (65-74 years), and admission rates for both hyperglycemia and hypoglycemia were 4-fold higher for black patients compared with white patients. The 30-day and 1-year mortality and 30-day readmission rates improved during the study period and were similar after an index hospitalization for either hyperglycemia or hypoglycemia (5.4%, 17.1%, and 15.3%, respectively, after hyperglycemia hospitalizations in 2010; 4.4%, 19.9%, and 16.3% after hypoglycemia hospitalizations). CONCLUSIONS AND RELEVANCE: Hospital admission rates for hypoglycemia now exceed those for hyperglycemia among older adults. Although admissions for hypoglycemia have declined modestly since 2007, rates among black Medicare beneficiaries and those older than 75 years remain high. Hospital admissions for severe hypoglycemia seem to pose a greater health threat than those for hyperglycemia, suggesting new opportunities for improvement in care of persons with diabetes mellitus.
- Publication
JAMA Internal Medicine, 2014, Vol 174, Issue 7, p1116
- ISSN
2168-6106
- Publication type
Article
- DOI
10.1001/jamainternmed.2014.1824