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2型糖尿病患者的低血糖与医疗费用:基于韩国国家糖尿病项目队列的分析

Hypoglycemia and Medical Expenses in Patients with Type 2 Diabetes Mellitus: An Analysis Based on the Korea National Diabetes Program Cohort.

作者信息

Rhee Sang Youl, Hong Soo Min, Chon Suk, Ahn Kyu Jeung, Kim Sung Hoon, Baik Sei Hyun, Park Yong Soo, Nam Moon Suk, Lee Kwan Woo, Woo Jeong-Taek, Kim Young Seol

机构信息

Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.

Department of Endocrinology and Metabolism, Graduate School of Medicine, Kyung Hee University, Seoul, Korea.

出版信息

PLoS One. 2016 Feb 18;11(2):e0148630. doi: 10.1371/journal.pone.0148630. eCollection 2016.

Abstract

BACKGROUND AND AIMS

Hypoglycemia is one of the most important adverse events in individuals with type 2 diabetes mellitus (T2DM). However, hypoglycemia-related events are usually overlooked and have been documented less in clinical practice.

MATERIALS AND METHODS

We evaluated the incidence, clinical characteristics, and medical expenses of hypoglycemia related events in T2DM patients based on the Korea National Diabetes Program (KNDP), which is the largest multi-center, prospective cohort in Korea (n = 4,350). For accurate outcomes, the KNDP data were merged with claims data from the Health Insurance Review and Assessment Service (HIRA) of Korea.

RESULTS

During a median follow-up period of 3.23 years (95% CI: 3.14, 3.19), 88 subjects (2.02%) were newly diagnosed with hypoglycemia, and the incidence of hypoglycemia was 6.44 cases per 1,000 person-years (PY). Individuals with hypoglycemia were significantly older (59.7±10.7 vs. 53.3±10.4 years, p < 0.001), had more hospital visits (121.94±126.88 days/PY, p < 0.001), had a longer hospital stays (16.13±29.21 days/PY, p < 0.001), and incurred greater medical costs ($2,447.56±4,056.38 vs. $1,336.37±3,403.39 /PY, p < 0.001) than subjects without hypoglycemia.

CONCLUSION

Hypoglycemia-related events were infrequently identified among the medical records of T2DM subjects. However, they were associated significantly with poor clinical outcomes, and thus, hypoglycemia could have a substantial burden on the Korean national healthcare system.

摘要

背景与目的

低血糖是2型糖尿病(T2DM)患者最重要的不良事件之一。然而,低血糖相关事件通常被忽视,在临床实践中的记录也较少。

材料与方法

我们基于韩国国家糖尿病项目(KNDP)评估了T2DM患者低血糖相关事件的发生率、临床特征和医疗费用,该项目是韩国最大的多中心前瞻性队列研究(n = 4350)。为获得准确结果,将KNDP数据与韩国健康保险审查与评估服务机构(HIRA)的理赔数据进行了合并。

结果

在中位随访期3.23年(95%CI:3.14,3.19)内,88名受试者(2.02%)新诊断为低血糖,低血糖发生率为每1000人年6.44例。低血糖患者年龄显著更大(59.7±10.7岁对53.3±10.4岁,p < 0.001),就诊次数更多(121.94±126.88天/人年,p < 0.001),住院时间更长(16.13±29.21天/人年,p < 0.001),且医疗费用更高(2447.56±4056.38美元/人年对1336.37±3403.39美元/人年,p < 0.001)。

结论

在T2DM患者的病历中,低血糖相关事件很少被识别。然而,它们与不良临床结局显著相关,因此,低血糖可能给韩国国家医疗保健系统带来沉重负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab6f/4758656/f4dd3f2574fa/pone.0148630.g001.jpg

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