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Introduction <p>Although many people with diabetes are treated with insulin in Japan, data on the incidence of hypoglycemia in this population are limited. This real-world, retrospective, cohort analysis assessed the incidence of hypoglycemia-related hospitalization, and the time to first hypoglycemia-related hospitalization, after insulin initiation in adults with type 2 diabetes (T2D) in Japan.</p> Methods <p>Adults with T2D who initiated basal, basal-bolus, or premix insulin between January 2016 and September 2022 were identified from the Medical Data Vision (MDV) database. Index date was defined as the date on which the first insulin prescription was issued. The 12&#xa0;months preceding and the 24&#xa0;months after this date comprised the baseline and follow-up periods, respectively. Inverse probability of treatment weighting was used to address potential confounding effects.</p> Results <p>Of 65,668 individuals in the weighted cohort (median [interquartile range] age, 66.00 [55.00, 73.00] years), 21,846 (33.27%) initiated basal insulin, 21,852 (33.28%) initiated basal-bolus insulin, and 21,969 (33.45%) initiated premix insulin. During the follow-up period, 150 individuals (0.23%) had a hypoglycemia-related hospitalization; incidence rate (95% confidence interval [CI]): 0.35 (0.29, 0.40) per 100 person-years. Of those 150 individuals, 89 (0.41%) in the basal-bolus group experienced hypoglycemia-related hospitalization compared with 29 (0.13%; <i>p</i> &lt; 0.001) and 33 (0.15%; <i>p</i> &lt; 0.001) in the basal and premix groups, respectively. There was a trend towards a higher risk of hypoglycemia-related hospitalization in the basal-bolus group than in either the basal (hazard ratio [HR] 0.32; 95% CI 0.15, 0.66; <i>p</i> = 0.002) or premix group (HR 0.36; 95% CI 0.13, 1.03; <i>p</i> = 0.056). The basal-bolus group had the shortest time to first hypoglycemia-related hospitalization compared with the basal and premix groups.</p> Conclusions <p>In adults with T2D in Japan, treatment with basal-bolus insulin was associated with a higher incidence of hypoglycemia-related hospitalization than with basal or premix insulin.</p>

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Hypoglycemia-Related Hospitalization in Adults with Type 2 Diabetes Receiving Insulin in Japan: Real-World Analysis Using the Medical Data Vision Database

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  • 发表日期：

    2025年8月28日

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  • Takeshi Miyatsuka,
  • Maiko Kino,
  • Elisabeth de Laguiche,
  • Onkar Kakade

摘要

Introduction

Although many people with diabetes are treated with insulin in Japan, data on the incidence of hypoglycemia in this population are limited. This real-world, retrospective, cohort analysis assessed the incidence of hypoglycemia-related hospitalization, and the time to first hypoglycemia-related hospitalization, after insulin initiation in adults with type 2 diabetes (T2D) in Japan.

Methods

Adults with T2D who initiated basal, basal-bolus, or premix insulin between January 2016 and September 2022 were identified from the Medical Data Vision (MDV) database. Index date was defined as the date on which the first insulin prescription was issued. The 12 months preceding and the 24 months after this date comprised the baseline and follow-up periods, respectively. Inverse probability of treatment weighting was used to address potential confounding effects.

Results

Of 65,668 individuals in the weighted cohort (median [interquartile range] age, 66.00 [55.00, 73.00] years), 21,846 (33.27%) initiated basal insulin, 21,852 (33.28%) initiated basal-bolus insulin, and 21,969 (33.45%) initiated premix insulin. During the follow-up period, 150 individuals (0.23%) had a hypoglycemia-related hospitalization; incidence rate (95% confidence interval [CI]): 0.35 (0.29, 0.40) per 100 person-years. Of those 150 individuals, 89 (0.41%) in the basal-bolus group experienced hypoglycemia-related hospitalization compared with 29 (0.13%; p < 0.001) and 33 (0.15%; p < 0.001) in the basal and premix groups, respectively. There was a trend towards a higher risk of hypoglycemia-related hospitalization in the basal-bolus group than in either the basal (hazard ratio [HR] 0.32; 95% CI 0.15, 0.66; p = 0.002) or premix group (HR 0.36; 95% CI 0.13, 1.03; p = 0.056). The basal-bolus group had the shortest time to first hypoglycemia-related hospitalization compared with the basal and premix groups.

Conclusions

In adults with T2D in Japan, treatment with basal-bolus insulin was associated with a higher incidence of hypoglycemia-related hospitalization than with basal or premix insulin.