Incidence and Costs of Hypoglycemia among Type II Diabetes Mellitus Patients in Turkey

Abstract

We aimed to determine the lifetime and one-year incidence of hypoglycemia in adults who had been treated following a diagnosis of Type II Diabetes Mellitus (T2DM), the factors that affected this incidence, and its effect on the use of health care resources. The descriptive cross-sectional cost study included adult T2DM patients who had an outpatient examination. Using a face-to-face interview method, patients were required to complete a questionnaire containing questions about sociodemographic characteristics, T2DM diagnosis and treatment features, and hypoglycemia events. Episode treatment costs of the patients in whom hypoglycemia was observed were calculated as direct cost per episode from the payer perspective. The mean age of the patients (n = 220) was 48.1 ± 11.8 (range 26-79) years, and the mean duration of disease was 4.5 ± 3.0 (range 1-16) years. According to treatment modalities, the frequency of hypoglycemia in the last year was 4.7% in the patients receiving oral antidiabetic drugs and 32.7% in the patients using insulin. In addition, 61.9% of the patients who had a hypoglycemic event in the last year presented to hospital, and 57.7% of these patients were hospitalized because of the hypoglycemic event. The incidence of hypoglycemia was 18 episodes of hypoglycemia per 100 patient years for T2DM patients and 25 severe hypoglycemia episodes per 100 patient years for patients using insulin. Significant predictors of hypoglycemia included insulin therapy (p = 0.000), regular use of medications (p = 0.013), hospitalization in the last year (p = 0.008), and exercise (p = 0.042). The average cost of a hypoglycemic event was calculated as Purchasing Power Parity İn Dollars ($PPP) 1.370.2 ± 1.407.0 (149.8-5,048.8). T2DM complications are the cause of a high economic burden. Hypoglycemia, which is one of these complications, is observed more frequently in patients who receive insulin therapy, who use regular medication, who do not exercise regularly, and who have been hospitalized in the last year.