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。