Documento de posicionamiento: evaluación y manejo de la hipoglucemia en el paciente concon diabetes mellitus. Grupo de Trabajo de Diabetes Mellitus de la Sociedad Española de Endocrinología y Nutrición

Mezquita-Raya, Pedro; Reyes-García, Rebeca; Moreno-Pérez, Óscar; Muñóz-Torres, Manuel; Merino-Torres, Juan Francisco; Gorgojo-Martínez, Juan J.; Jódar-Gimeno, Esteban; Escalada, Javier; Gargallo-Fernández, Manuel; Soto-González, Alfonso; Villar, Noemí González Pérez de; Fernández, Antonio B.; Guerrero, Diego Bellido; Botella-Serrano, Marta; Gómez-Peralta, Fernando; Casares, Martín López de la Torre

doi:10.1016/j.endonu.2013.04.005

Cited by 20 publications

(12 citation statements)

References 130 publications

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“…Spanish guidelines for the management of hypoglycemia recommend SMBG testing when hypoglycemia is suspected and after treatment until normal blood glucose levels have been restored [ 5 ]. The same questionnaire-based study that informed the hypoglycemia rates for this analysis reported that, in the 7 days following a non-severe episode, patients with T1DM used an average of 5.0 extra SMBG tests and patients with T2DM used an average of 5.9 extra tests [ 8 ].…”

Section: Methodsmentioning

confidence: 99%

“…Hypoglycemic episodes are treated with carbohydrates (e.g., a snack or sweet drink), glucose, or glucagon. Spanish guidelines for the management of hypoglycemia recommend treatment with 15 g glucose in conscious patients, which should be repeated after 15 min if an SMBG measurement shows persistent hypoglycemia [ 5 ]. A slow release carbohydrate should also be taken once blood glucose levels have returned to normal to prevent repeat hypoglycemia.…”

Section: Methodsmentioning

confidence: 99%

“…A slow release carbohydrate should also be taken once blood glucose levels have returned to normal to prevent repeat hypoglycemia. Subcutaneous glucagon is recommended in unconscious patients [ 5 ]. For severe episodes treated in hospital, the cost of treatment (glucose or glucagon) was assumed to be included in the ambulance cost, A&E tariff, or hospitalization tariff, and was therefore not included to avoid double counting.…”

Section: Methodsmentioning

confidence: 99%

“…Both the ADA/EASD and IDF guidelines recommend intensifying treatment if glycemic control has not been achieved after 3 months of therapy [ 3 , 4 ]. In Spanish guidelines for the management of hypoglycemia in diabetes, metformin is recommended as a first option partly due to its low hypoglycemia risk, and basal insulin analogues are recommended as subcutaneous therapy to decrease the risk of hypoglycemia, particularly nocturnal hypoglycemia [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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The Economic Burden of Insulin-Related Hypoglycemia in Spain

Parekh

Hoskins²,

Baker‐Knight³

et al. 2017

Diabetes Ther

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IntroductionAn analysis was conducted to estimate the economic burden of insulin-related hypoglycemia in adults in Spain, derived from a novel concept developed for the UK known as the Local Impact of Hypoglycemia Tool.MethodsCosts per severe and non-severe hypoglycemic episode were calculated for patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM). The costs per episode were applied to the population of adults with T1DM and T2DM using insulin in Spain according to the number of severe and non-severe episodes experienced per year. Costs were calculated using Spanish-specific resource costs and published values for resource utilization, including ambulance, accident and emergency (A&E) department, hospitalization, healthcare professional visits, and extra self-monitoring of blood glucose (SMBG) tests used in the week following the episode. A one-way sensitivity analysis on all model inputs was then performed.ResultsThe cost of insulin-related hypoglycemia in Spain is estimated as €662.0 m per year, €292.6 m of which is due to severe episodes and €369.4 m to non-severe episodes. The cost per episode varies from €1.25 for patients with T1DM and €1.48 for patients with T2DM for a non-severe episode where extra SMBG testing after the episode is the only action taken, to €4378.22 for T1DM and €3005.74 for T2DM for a severe episode that was treated in hospital and requires an ambulance, A&E visit, hospitalization, and a diabetes specialist visit. A reduction in severe and non-severe hypoglycemia rates of just 20% could lead to considerable cost savings of €284,925 per 100,000 general population.ConclusionThis analysis highlights the substantial economic burden of hypoglycemia in Spain, and gives budget holders the ability to assess the costs of new treatments or patient education programs in relation to the potential cost savings due to lower hypoglycemia rates.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Economic Burden of Insulin-Related Hypoglycemia in Spain

Parekh

Hoskins²,

Baker‐Knight³

et al. 2017

Diabetes Ther

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“…This number is estimated to increase to 628.60 million (9.90%) by 2045 [ 2 ]. A survey was conducted in 2009–2010 with the aim to quantify the prevalence of DM in Spain [ 3 ]; at that time it was estimated that DM affected 13.80% of the population and that these numbers would likely increase given estimated global figures [ 4 ]. In addition, global expenditure attributable to the care of DM patients has become an enormous economic burden on healthcare services, reaching US $727 billion in 2017 [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology, Quality of Life, and Costs Associated with Hypoglycemia in Patients with Diabetes in Spain: A Systematic Literature Review

et al. 2019

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Objective To assess the burden of hypoglycemia in patients with diabetes mellitus (DM) in Spain, including epidemiological data and information relating to healthcare resource utilization (HRU) and costs, and patients’ quality of life (QoL). Methods A systematic literature review (SLR) was conducted to identify studies that included original information on epidemiology, HRU and costs, and/or QoL associated with hypoglycemia in patients with DM in Spain, published in either Spanish or English, between January 2007 and April 2017. Results Fifteen articles, involving 14 studies, were identified in the SLR and included in the analysis. The estimated rate of severe hypoglycemia (SH) events per patient per year ranged from 0.90 to 1.50 in patients with type 1 DM (T1DM) and from 0.30 to 0.63 in patients with type 2 DM (T2DM). The data on HRU differed extensively between studies, making it difficult to draw a conclusion. Total costs per SH event ranged from €409.97 in patients with T1DM to €713.10 in patients with DM. Work absence was reported in 11.80–18% of the working patients. Further, patients who experienced hypoglycemic events expressed a higher fear and had a poorer QoL than those who did not report these events. Conclusion Although the data included in the SLR were difficult to synthesize due to heterogeneity of the study designs and patient characteristics in the 14 studies, our search identified a high burden associated with hypoglycemic events in terms of HRU and costs, and patients’ QoL. Further research is recommended to reach a consensus on hypoglycemia definition and study design to provide robust evidence on the burden of hypoglycemia and to accurately weigh the impact of this acute complication in Spain. Funding Eli Lilly and Company.

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Health Care, Insurance, and School Policy Affecting Diabetes in the Pediatric Population

Fisher

Vidmar

2020

Behavioral Diabetes

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Documento de posicionamiento: evaluación y manejo de la hipoglucemia en el paciente concon diabetes mellitus. Grupo de Trabajo de Diabetes Mellitus de la Sociedad Española de Endocrinología y Nutrición

Cited by 20 publications

References 130 publications

The Economic Burden of Insulin-Related Hypoglycemia in Spain

The Economic Burden of Insulin-Related Hypoglycemia in Spain

Epidemiology, Quality of Life, and Costs Associated with Hypoglycemia in Patients with Diabetes in Spain: A Systematic Literature Review

Health Care, Insurance, and School Policy Affecting Diabetes in the Pediatric Population

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