OBJECTIVES: Severe Hypoglycemia (SH) is an important complication requiring assistance from other persons. This study aimed to describe profiles of patients with SH based on different characteristics.

METHODS: This retrospective study utilized IBM MarketScan Research Database to observe patients experiencing SH between December 2016 and November 2017. A total of 335,766 patients met these following inclusion criteria: presence of diabetes and insulin claims, and continuous enrollment in health plans. Patients with at least one SH were identified using ICD-9-CM/ICD-10-CM codes who were initially treated by emergency medical services or emergency department. Patient characteristics, including age, insurance type, diabetes type, and insulin use, were examined.

RESULTS: During the one-year observation period, 9,563 (2.8%) patients with SH were identified with a mean age of 54 years. Of those, 37.7% were Type 1 diabetes (T1D) and 62.3% were Type 2 diabetes (T2D). Overall, the groups that accounted for the largest number of patients with SH were Medicaid adults with T2D using Basal and Bolus (B/B) insulin group (N = 1,638, 17.1%) followed by commercially insured adults with T1D using B/B insulin group (N = 1,488, 15.6%). Among T1D patients with SH (N = 3,602), commercially insured adults using B/B insulin group (41.3%) accounted for the largest proportion. Among T2D patients with SH (N = 5,961), Medicaid adults using B/B insulin group (27.5%) accounted for the largest proportion. Among Medicare patients with SH (N=2,442), T2D patients using B/B insulin group (54.8%) and T2D patients using basal insulin only group (24.8%) made up more than three quarters of the sample.

CONCLUSIONS: This study reveals characteristics (e.g., Medicaid adults with T2D using B/B insulin; Medicare patients with T2D using basal insulin only) that may benefit from targeted interventions to prevent SH. Continued research is warranted concerning the financial burden of SH and impact of interventions on different patient profile groups.