PMID- 25726033
OWN - NLM
STAT- MEDLINE
DCOM- 20151201
LR  - 20240110
IS  - 2376-1032 (Electronic)
IS  - 2376-0540 (Print)
IS  - 2376-0540 (Linking)
VI  - 21
IP  - 3
DP  - 2015 Mar
TI  - Association between hypoglycemia and fall-related events in type 2 diabetes 
      mellitus: analysis of a U.S. commercial database.
PG  - 243-53
LID - 10.18553/jmcp.2015.21.3.243
AB  - BACKGROUND: Hypoglycemia is a major barrier to achieving optimal glycemic control 
      and managing diabetes successfully in patients with diabetes. Falls are the most 
      significant consequences caused by hypoglycemia episodes. Both hypoglycemia and 
      falls lead to substantial economic burden on the health care system in the United 
      States. OBJECTIVE: To examine the association of hypoglycemia with fall-related 
      outcomes in elderly patients with type 2 diabetes mellitus (T2DM). METHODS: 
      Records were obtained for T2DM patients (N = 1,147,937) from January 1, 2008, to 
      December 31, 2011. The nonhypoglycemia patients were randomly matched 1:1 by age 
      and gender to the hypoglycemia patients. Fall-related events (composite of 
      fall-related outcomes) were defined using ICD-9-CM codes. Conditional logistic 
      regression models were used to compare the fall-related events within 30 days, 90 
      days, 180 days, and 365 days between the 2 cohorts. RESULTS: A total of 21,613 
      hypoglycemia patients were matched with 21,613 nonhypoglycemic patients. Patients 
      with hypoglycemia had higher fall-related events within 30 days, 90 days, 180 
      days, and 365 days (P  less than  0.001 for all frequency differences). 
      Conditional logistic regression analyses showed an elevated risk for fall-related 
      events over 365 days (aOR = 1.95, 95% CI = 1.70-2.24). Subgroup analysis showed 
      elevated risk for patients aged less than  75 years and >/= 75 years. Elevated 
      risks were also seen for individual fall-related outcomes of fractures, head 
      injuries, long-term care placement, and hospital admissions. CONCLUSIONS: The 
      risk of fall-related events over 365 days increased 2-fold among elderly patients 
      with diabetes who experienced hypoglycemia.
FAU - Kachroo, Sumesh
AU  - Kachroo S
AD  - Tulane University, 1440 Canal St., New Orleans, LA 70112. lshi1@tulane.edu.
FAU - Kawabata, Hugh
AU  - Kawabata H
FAU - Colilla, Susan
AU  - Colilla S
FAU - Shi, Lizheng
AU  - Shi L
FAU - Zhao, Yingnan
AU  - Zhao Y
FAU - Mukherjee, Jayanti
AU  - Mukherjee J
FAU - Iloeje, Uchenna
AU  - Iloeje U
FAU - Fonseca, Vivian
AU  - Fonseca V
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Manag Care Spec Pharm
JT  - Journal of managed care & specialty pharmacy
JID - 101644425
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Accidental Falls/economics/*statistics & numerical data
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Cohort Studies
MH  - Cost of Illness
MH  - Databases, Factual
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Female
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Hypoglycemia/*complications/economics/epidemiology
MH  - Hypoglycemic Agents/*adverse effects/therapeutic use
MH  - Logistic Models
MH  - Male
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Time Factors
MH  - United States/epidemiology
PMC - PMC10398265
COIS- This study was funded by an unrestrictive grant from Bristol-Myers Squibb to 
      Tulane University. Iloeje and Kachroo were employees of Bristol-Myers Squibb when 
      this study was conducted and have no conflict of interest with regards to this 
      study. Kawabata, Colilla, and Mukherjee are employees of Bristol-Myers Squibb. 
      Zhao and Shi declare no conflict of interest with regards to this study. Fonseca 
      has received grants from Novo Nordisk, Asahi, Eli Lilly, Abbott, and Endo 
      Barrier, as well as honoria for consulting and lectures from GlaxoSmithKine, 
      Takeda, Novo Nordisk, Sanofi-Aventis, Eli Lilly, Daiichi Sankyo, Pamlabs, 
      Astra-Zeneca, Abbott, Bristol-Myers Squibb, Boehringer Ingelheim, and Janssen. 
      Results of this manuscript were presented at the European Association for the 
      Study of Diabetes 49th Conference; Barcelona, Spain; 2013. Fonseca, Kachroo, Shi, 
      Mukherjee, and Iloeje conceptualized the study design. Shi and Kawabata 
      coordinated data analyses. Colilla conducted data analysis and consulted in the 
      analysis plan. Shi and Kachroo led the development of the manuscript. All authors 
      participated in interpreting the results and commenting on the manuscript.
EDAT- 2015/03/03 06:00
MHDA- 2015/12/15 06:00
PMCR- 2015/03/01
CRDT- 2015/03/02 06:00
PHST- 2015/03/02 06:00 [entrez]
PHST- 2015/03/03 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
PHST- 2015/03/01 00:00 [pmc-release]
AID - 2015(21)3: 243-253 [pii]
AID - 10.18553/jmcp.2015.21.3.243 [doi]
PST - ppublish
SO  - J Manag Care Spec Pharm. 2015 Mar;21(3):243-53. doi: 10.18553/jmcp.2015.21.3.243.