OBJECTIVES: Hypoglycemia is a concern for patients in an inpatient setting with diabetes. The objective is to report the length of stay, hospital costs, and place of discharge for patients with diabetes on subcutaneous insulin who had a hypoglycemic event compared to those who did not experience a hypoglycemic event during their hospital stay.

METHODS: A retrospective study was performed using the Premier Healthcare Database of adult diabetes patients who received subcutaneous insulin during an inpatient stay between October 2015 and March 2018. Hospital costs and length of stay were compared for encounters for patients who developed hypoglycemia during their stay vs. without. Encounters including intravenous insulin use, ICU, or hypoglycemia on admission were excluded. Propensity score matching (1:1 ratio) was used to balance observed differences in patient demographics, Charlson Comorbidity Index (CCI) score, comorbidities, primary diagnosis, primary procedures and hospital characteristics. To compare cohort differences, Wilcoxon rank sum, chi-square tests, and generalized linear models (GLMs) were used.

RESULTS: A total of 936,957 diabetes patient encounters were identified. 14,352 had a hypoglycemic event and 922,605 did not report any hypoglycemia. In the matched cohorts (n=14,352 each), approximately 50% were male and the mean age was 65 years. The cohort experiencing hypoglycemia demonstrated significantly higher costs compared to the cohort without hypoglycemia (mean $24,162/median $14,511 vs. mean $18,630/median $11,193, p<0.0001). The cohort experiencing hypoglycemia had longer length of stays than those not experiencing hypoglycemia (mean 10/median 7 days vs mean 7/median 5 days, p<0.0001). 24% of the cohort experiencing hypoglycemia was discharged to a skilled nursing facility compared to 20% without hypoglycemia events (p<0.0001).

CONCLUSIONS: Higher costs and longer length of stays were associated with hospital encounters for patients with diabetes on subcutaneous insulin who experienced a hypoglycemic event.