This article is more than 5 years old. Information may no longer be current.
High costs accompany hyperglycemic crisis
In adults with diabetes, hyperglycemic crises, including diabetic ketoacidosis and hyperosmolar hyperglycemic state, have a substantial economic impact on the health system in Spain, published data show.
Fernando Gomez-Peralta, MD, PhD, of the endocrinology and nutrition unit, Segovia General Hospital in Spain, and colleagues evaluated 1,137,738 emergency calls from the 2012 Healthcare Emergency Public Service database in Andalusia to determine the incidence, recurrence and cost of hyperglycemic crises in people with diabetes.
Overall, 11,907 of the calls were for hyperglycemia; a diagnosis of hyperglycemic crises was made by physicians in 50.1% of the episodes. Among adults with diabetes, the overall incidence of hyperglycemic crises was 2.9 cases per 1,000 persons with diabetes, the incidence of diabetic ketoacidosis was 2.5 cases per 1,000 persons with diabetes, and the incidence of hyperosmolar hyperglycemic state was 0.4 cases per 1,000 persons with diabetes.
During the 1-year study period, 17.7% of the 2,484 adults who received assistance experienced a recurrent episode of hyperglycemic crisis; 64.5% experienced two, 23.6% experienced three, 8.2% experienced four and 3.9% experienced five or more.
Hyperglycemic crises in Andalusia in 2012 yielded a total direct cost of 4,662,151 euros, for a mean cost per episode of 1,476 euros. Emergency care in the hospital contributed the greatest percentage of the mean cost per episode (59.6%) followed by out-of-hospital medical assistance (33.1%) and transport to the hospital (7.3%).
“The results of this study underscore the high economic cost of episodes of hyperglycemic crisis in persons with diabetes,” the researchers wrote. “Although cases of ketoacidosis are relatively more common in young people, the majority of hyperglycemic crises occur in adults. Because hyperglycemic crises recur frequently, it would be advisable to design specific prevention programs for higher-risk individuals. As both the frequency of cases of hyperglycemic crises and the rate of recurrence seem to be higher in women than in men, this issue needs to be specifically investigated to find the causes and reduce their occurrence.” – by Amber Cox
Disclosure: Gomez-Peralta reports various financial ties with AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals, Bristol-Myers Squibb Company, Lilly, Novo Nordisk and Sanofi. Please see the full study for a list of all other authors’ relevant financial disclosures.