Incidence of severe hypoglycaemic episodes in patients with type 2 diabetes in the Basque country: Impact on healthcare costs Utilization, expenditure, economics and financing systems

Abstract

Background: Hypoglycaemia is an acute complication of diabetes mellitus which poses a serious threat. This study aims to describe the annual rate of people suffering episodes of severe hypoglycaemia and to estimate the healthcare costs for individuals who have suffered such events. Methods: A descriptive study involving all patients with type 2 diabetes (T2DM) from the Basque Country (period: 1/09/2010 to 31/08/2011) aged ≥ 35 years (N = 134,413). The rate of hypoglycaemic episodes treated in hospitals (Accident and Emergency and in-patient services) was calculated using an algorithm based on diagnostics and laboratory tests. The variables recorded included demographic, comorbidity (diagnoses categorised using the Adjusted Clinical Groups case-mix system) and socioeconomic variables (deprivation index of the area of residence). The annual healthcare cost for people with T2DM who suffered those episodes was compared with those who did not by regression analysis. Results: The incidence of hypoglycaemia in the Basque Country was 0.56 %. This percentage was higher among women and people with a lower socioeconomic status. These episodes were associated with age and high values of glycosylated haemoglobin (HbA 1c) > 7 %. Adjusting for the other variables, on average, people who suffered hypoglycaemia accounted for an additional €2509 in annual healthcare costs. Conclusions: Hypoglycaemia has high morbi-mortality and a major economic impact. As such, health services must monitor its appearance and promote specific actions, especially in the higher risk sub-populations.