Format

Send to

Choose Destination
J Diabetes Complications. 2017 May;31(5):869-873. doi: 10.1016/j.jdiacomp.2017.02.009. Epub 2017 Feb 21.

High rates of severe hypoglycemia among African American patients with diabetes: the surveillance, prevention, and Management of Diabetes Mellitus (SUPREME-DM) network.

Author information

1
Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612. Electronic address: andy.j.karter@kp.org.
2
Section of Endocrinology, Department of Internal Medicine, Yale School of Medicine, PO Box 208020, New Haven, CT 06520.
3
HealthPartners Institute, P.O. Box 1524, Minneapolis, MN 55440.
4
Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612.
5
Institute for Health Research, Kaiser Permanente Colorado, PO Box 378066, Denver, CO 80237.
6
Department of Research and Evaluation, Kaiser Permanente Southern California, 100 South Los Robles Avenue, 2nd Floor, Pasadena, CA 91101.
7
Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest, 3800 N. Interstate Avenue, Portland, OR 97227.
8
Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101.
9
Department of Endocrinology, Marshfield Clinic, 1000 North Oak Avenue, Marshfield, WI 54449.
10
Center for Health Research, Kaiser Permanente Hawaii, 501 Alakawa Street, Suite 201, Honolulu, HI 96817.
11
Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, 3495 Piedmont Road NE, Building 11, Suite 110, Atlanta, GA 30305.
12
Department of Medicine, New York University (NYU) Lutheran, 150 55th St, Brooklyn, NY 11220.

Abstract

AIMS:

Seven-year surveillance study (2005-2011) to evaluate race/ethnic differences in the trends in rates of severe hypoglycemia (SH) in a population of insured, at-risk adults with diabetes.

METHODS:

SH events were identified via any primary or principal diagnosis from emergency department or inpatient encounters among African American, Asian, Latino and White adult diabetes patients treated with insulin or secretagogues (Sulfonylureas or Meglitinides), receiving care from integrated healthcare delivery systems across the United States. We calculated age- and sex-standardized annual SH rates and average annual percent change (AAPC) in SH rates.

RESULTS:

Annual SH rates ranged from 1.8% to 2.1% during this 7-year observation period (2,200,471 person-years). African Americans had consistently higher SH rates compared with Whites, while Latinos and Asians had consistently lower rates compared with Whites in each of the 7 years (all p < 0.01). The trend increased significantly only among African Americans (AAPC = +4.3%; 95% CI: +2.1, +6.5%); in the other groups, the AAPC was not significantly different from zero.

CONCLUSIONS:

Surveillance efforts should monitor the racial/ethnic-specific rates. The factors underlying substantially higher rates of hypoglycemia in African Americans should be evaluated. Clinically and culturally-appropriate strategies to reduce the risk of SH need to be developed and tested.

KEYWORDS:

Complications; Hypoglycemia; Insulin; Insulin secretagogues; Racial differences; Sulfonylureas

PMID:
28319006
PMCID:
PMC5491095
DOI:
10.1016/j.jdiacomp.2017.02.009
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center