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Research Letter
July 2018

Surveillance of Hypoglycemia—Limitations of Emergency Department and Hospital Utilization Data

Author Affiliations
  • 1Division of Research, Kaiser Permanente, Oakland, California
  • 2Section of Endocrinology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
JAMA Intern Med. 2018;178(7):987-988. doi:10.1001/jamainternmed.2018.1014

Hypoglycemia is a common and life-threatening adverse drug event associated with glucose-lowering medications. Hypoglycemia is classified as severe when assistance from another person is required to actively administer carbohydrates, glucagon, or other resuscitative actions.1 Surveillance in the United States has relied on data from electronic medical records (EMR) or administrative claims from emergency department (ED) visits and hospital admissions for hypoglycemia, which are presumably the most severe and costly events.2,3 However, this surveillance fails to account for events treated outside of the health care system (eg, by family members). We estimated the proportion of all severe hypoglycemic events that are captured by surveillance based on health care utilization alone among pharmacologically treated patients with diabetes.

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