Trends and Disparities in U.S. Emergency Department Visits for Hypoglycemia, 1993–2005

Abstract

OBJECTIVE—To characterize the epidemiology of hypoglycemia in U.S. emergency departments. RESEARCH DESIGN AND METHODS—We analyzed data from the 1993–2005 National Hospital Ambulatory Medical Care Survey and evaluated trends and disparities over time. RESULTS—There were ∼5 million emergency department visits for hypoglycemia from 1993–2005, and 25% resulted in hospital admission. The visit rate per 1,000 of the diabetic population was 34 (95% CI 30–37) and did not change significantly during the study period (P = 0.70 for trend). These visit rates were higher in patients aged <45 years (n = 62) and ≥75 years (n = 54) versus those aged 45–74 years (n = 21), in female (n = 37) versus male (n = 30) patients, in black (n = 40) vs. white (n = 25) patients, and in Hispanic (n = 21) versus non-Hispanic (n = 12) patients (all P < 0.001). CONCLUSIONS—Greater emphasis on intensive glycemic control has not resulted in increased emergency department visit rates for hypoglycemia. We identified demographic disparities, however, that merit further evaluation. The emergency department provides an important opportunity for epidemiologic study and intervention for severe hypoglycemia.