Researchers have developed a new tool that could help to classify patients with type 2 diabetes at greater risk for hypoglycemia-related utilization using only six information inputs, according to the results of a study published in JAMA Internal Medicine. This tool could help to target interventions to those patients most in need.
“Hypoglycemia is now one of the most frequent adverse events in patients with type 2 diabetes; when not treated, it can lead to falls, car accidents, heart attacks and even death,” Andrew Karter, PhD, research scientist at Kaiser Permanente Northern California’s Division of Research, told Medical Economics. “Hypoglycemia is often preventable with the proper clinical attention, and we believe this tool will help focus that attention on the patients who most need it.”
To develop this tool, Karter and colleagues created a classification tree based on potential predictors of hypoglycemia-related emergency department (ED) or hospital use. This tree was transcribed into a tool and tested in one internal and two independent external samples. Internal testing was done with 206,435 patients with diabetes from Kaiser Permanente Northern California (KPNC), and external testing was done with 1,335,966 Veterans Health Administration and 14,972 Group Health Cooperative patients with type 2 diabetes.
The tool was based on six patient-specific variables: total number of prior episodes of hypoglycemia-related ED or hospital utilization; number of ED encounters for any reason in the prior 12 months; insulin use; sulfonylurea use; presence of severe or end-stage kidney disease; and age younger than 77 years. Based on responses, patients were classified as high (>5%), intermediate (1%-5%) or low (<1%) risk.