Department of Pharmacy, University Hospital of Strasbourg, NHC, Service de Pharmacie, 1, Place de l'Hôpital, 67091, Strasbourg Cedex, France.
Faculty of Pharmacy, University of Strasbourg, Strasbourg, France.
Int J Clin Pharm. 2019 Oct;41(5):1159-1165. doi: 10.1007/s11096-019-00877-5. Epub 2019 Jul 23.
Background Hypoglycemia is an acute and frequent complication of diabetes. Objectives To assess the number of hospital admissions due to iatrogenic hypoglycemia in Alsace (France) over a year, to estimate the associated economic burden and to identify causes. Method A retrospective analysis was performed using data extracted from hospital databases. Costs were calculated from French official tariffs. Setting 31 public and private hospitals. A review of the medical records of patients with iatrogenic hypoglycemia-related hospital admissions was performed at the University Hospital of Strasbourg. Main outcome measures Hypoglycemia-related hospital admissions: number, costs and causes. Results Out of 42,381 hospitalizations, 147 iatrogenic hypoglycemia-related hospital admissions (0.4%) were identified; 41 patients with type 1 diabetes mellitus and 106 with type 2. The total cost associated to the 147 events was € 407,441. The median cost per patient was € 1,224.6 [563.0-2,505.7 (interquartile range)] for type 1 diabetes mellitus and € 3,670.9 [2,505.7-3,670.9] for type 2. Forty-six patients over the 147 were coming from the University Hospital of Strasbourg. In this hospital, the most common origin of the hypoglycemia was missed meals (n = 7), the second was a mismatch between antidiabetic medicines and carbohydrate intake (n = 6), the third was an incorrect use of antidiabetic medicines (n = 5). Conclusions 147 hospitalizations due to iatrogenic hypoglycemia were identified with an estimated global cost of € 407,441. Optimizing therapy with low-risk hypoglycemic medicines, improving access to continuous glucose monitoring systems and offering adequate education, could help address the causes of hypoglycemia.
背景 低血糖是糖尿病的一种急性且常见的并发症。目的 评估法国阿尔萨斯地区一年内因医源性低血糖导致的住院人数，估算相关经济负担并确定病因。方法 回顾性分析从医院数据库中提取的数据。成本根据法国官方费率计算。地点 31 家公立和私立医院。在斯特拉斯堡大学医院对因医源性低血糖相关住院的患者的医疗记录进行了审查。主要观察指标 低血糖相关住院：数量、成本和病因。结果 在 42381 例住院患者中，确定了 147 例与医源性低血糖相关的住院（0.4%）；其中 41 例为 1 型糖尿病，106 例为 2 型糖尿病。147 例事件相关的总费用为 407441 欧元。每位患者的中位数费用为 1224.6 欧元[563.0-2505.7（四分位距）]，1 型糖尿病为 1224.6 欧元，2 型糖尿病为 3670.9 欧元。在这 147 例患者中，有 46 例来自斯特拉斯堡大学医院。在这家医院，低血糖最常见的原因是漏餐（n=7），其次是降糖药物与碳水化合物摄入不匹配（n=6），第三个原因是降糖药物使用不当（n=5）。结论 确定了 147 例因医源性低血糖导致的住院，估计总费用为 407441 欧元。通过优化低血糖风险低的药物治疗、改善连续血糖监测系统的可及性以及提供充分的教育，可能有助于解决低血糖的病因。
