Merck & Co., Inc., Kenilworth, NJ, USA.
Merck & Co., Inc., Kenilworth, NJ, USA.
J Diabetes Complications. 2017 Nov;31(11):1620-1623. doi: 10.1016/j.jdiacomp.2017.07.012. Epub 2017 Jul 28.
The objective of this study was to evaluate diabetes-related healthcare resource use and associated costs in patients with type 2 diabetes (T2DM) treated with a sulfonylurea (SU), with and without hypoglycemia.
In this retrospective cohort study, patients 18years or older receiving SU monotherapy or as add-on to metformin were identified from a US healthcare claims database (MarketScan®). Of 113,743 patients (56.8% male, average age 62.6years), 61.6% were on SU/metformin dual therapy and 38.4% were on SU monotherapy, and 5% had one or more episodes of hypoglycemia during the 12-month follow-up period.
Adjusted for baseline characteristics, patients with hypoglycemia were three times more likely than those without to use emergency room services (OR 3.04, 95% CI: 2.82, 3.25), almost four times more likely to have inpatient admissions (OR 3.84, 95% CI: 3.58, 4.12), and had more frequent physician office visits (4.3 vs 3.0 visits, p<0.01) in the 12-month follow-up period. The adjusted annual diabetes-related medical expenditure was three times higher in patients with hypoglycemia compared with those without ($6884 vs $2392, p<0.001).
This study demonstrated the higher healthcare utilization and costs associated with hypoglycemia in patients with T2DM treated with an SU.
本研究旨在评估接受磺酰脲类药物（SU）治疗的 2 型糖尿病（T2DM）患者的糖尿病相关医疗资源使用情况和相关费用，包括有无低血糖事件。
本回顾性队列研究从美国医疗保健索赔数据库（MarketScan®）中确定了接受 SU 单药治疗或与二甲双胍联合治疗的 18 岁及以上的患者。在 113743 例患者中（56.8%为男性，平均年龄 62.6 岁），61.6%接受 SU/二甲双胍联合治疗，38.4%接受 SU 单药治疗，5%在 12 个月的随访期间发生过一次或多次低血糖事件。
调整基线特征后，与无低血糖事件的患者相比，有低血糖事件的患者使用急诊服务的可能性增加了三倍（OR 3.04，95%CI：2.82，3.25），住院的可能性增加了近四倍（OR 3.84，95%CI：3.58，4.12），并且在 12 个月的随访期间，就诊次数也更为频繁（4.3 次 vs 3.0 次，p<0.01）。与无低血糖事件的患者相比，有低血糖事件的患者在调整后的年度糖尿病相关医疗支出高出三倍（$6884 美元 vs $2392 美元，p<0.001）。
本研究表明，与无低血糖事件的患者相比，接受 SU 治疗的 T2DM 患者发生低血糖事件会导致更高的医疗保健利用和成本。
