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Editor's Note
July 2014

Hospital Admissions for Hypoglycemia Now Exceed Those for Hyperglycemia in Medicare Beneficiaries

JAMA Intern Med. 2014;174(7):1125. doi:10.1001/jamainternmed.2014.2192

We were pleased to read the recent Centers for Disease Control and Prevention report1 that myocardial infarction, stroke, and hyperglycemia rates have been reduced for patients with diabetes mellitus. However, Lipska et al2 inform us that during the same time period, from 1999 to 2011, the opposite trend is occurring for hypoglycemia, and rates of hospital admissions for hypoglycemia have risen by 11.7% in US Medicare beneficiaries. In fact, there were 40% more admissions for hypoglycemia than for hyperglycemia over the 12-year period. The 1-year mortality rate after a hypoglycemia admission was higher (22.6%) than the rate after a hyperglycemia admission (17.6%) in 2010. Our patients are now more likely to experience adverse events related to overtreatment of diabetes mellitus. Striving for too low a hemoglobin A1c target level puts patients at risk for this dangerous adverse effect.