Hypoglycemia hospitalization frequency in patients with type 2 diabetes mellitus: a comparison of dipeptidyl peptidase 4 inhibitors and insulin secretagogues using the French health insurance database

Figures & data

Table 1 Characteristics of the EGB cohorts (all types of DPP4-i, vildagliptin, IS)

	DPP4-I N=7,152	Vildagliptin N=1,440	IS N=10,019	P-value*
Age at first dispensing in years (m(std))	63.7 (11.9)	63.5 (11.9)	67.3 (12.8)	<0.0001
Age in classes
<55	21.8%	22.6%	16.3%	<0.0001
55–64	31.3%	31.4%	25.3%
65–74	26.5%	25.4%	25.8%
75 and over	20.4%	20.7%	32.7%
Sex (% male)	53.1%	54.7%	53.9%	NS
% with ALD status	86.7%	86.7%	78.7%	<0.0001
% with CMU status	9.2%	9.0%	8.9%	NS
Exposure time in months (m(std))	13.6 (12.6)	4.8 (5.5)	29.4 (17.2)	<0.0001
Exposure time in classes
≤6 months	43.7%	85.7%	16.0%	<0.0001
7–12 months	14.1%	5.6%	8.7%
13–18 months	10.9%	4.0%	7.6%
19–24 months	10.0%	2.1%	7.2%
25–30 months	7.8%	1.3%	6.3%
>30 months	13.5%	1.3%	54.3%

Note:

* P-values were similar considering either the comparison of the DPP4-i cohort versus the IS cohort, or the vildagliptin cohort versus the IS cohort.

Abbreviations: EGB, Echantillon Généraliste des Bénéficiaires; DPP4-i, dipeptidyl peptidase 4 inhibitors; IS, insulin secretagogues; NS, not significant; ALD, specific coverage for long-standing conditions; CMU, specific coverage for deprived people; m, mean; std, standard deviation.

Table 2 Unadjusted comparison of the frequency of events in the EGB cohorts (all types of DPP4-i, vildagliptin, IS)

	DPP4-i N=7,152	Vildagliptin N=1,440	IS N=10,019	P-value*	P-value**
Person-years of exposure	8,105	581	24,585
Number of patients admitted to hospital for hypoglycemia (%)	8 (0.11%)	0 (0.0%)	130 (1.30%)
Number of hospital admissions for hypoglycemia	11	0	138
Crude incidence rate of hospital admissions for hypoglycemia/1,000 patient-years, m (95% CI)	1.4 (0.7; 2.4)	0.0 (0.0; 0.0)	5.6 (4.7; 6.6)	<0.0001	=0.0199
Number of patients visiting the ED (for any reason) (%)	799 (11.17%)	60 (4.20%)	2,144 (21.40%)
Number of ED visits	1,069	77	3,254
Crude incidence rate of ED visits/1,000 patient-years, m (95% CI)	131.9 (124.1; 140.0)	132.6 (104.6; 165.6)	132.4 (127.8; 136.9)	=0.4616;	=0.4882

Notes:

* DPP4-i versus IS;

** vildagliptin versus IS.

Abbreviations: EGB, Echantillon Généraliste des Bénéficiaires; DPP4-i, dipeptidyl peptidase 4 inhibitors; IS, insulin secretagogues; ED, emergency department; IS, insulin secretagogues; m, mean.

Table 3 Adjusted comparison by direct standardization of the frequency of events in the EGB cohorts (whole DPP4-i class, vildagliptin, IS)

	DPP4-i N=7,152	IS N=10,019	P-value	Vildagliptin N=1,440	IS N=10,019	P-value
Person-years of exposure	8,105	12,036		581	4,403
Number of patients admitted to hospital for hypoglycemia (%)	8 (0.11%)	88 (0.88%)	<0.0001	0 (0.0%)	59 (0.59%)	=0.0034
Number of hospital admissions for hypoglycemia	11	90		0	60
Adjusted incidence rate of hospital admissions for hypoglycemia/1,000 patient-years, m (95% CI)	1.4 (0.7; 2.4)	7.5 (6.0; 9,2)	<0.0001	0.0 (0.0; 0.0)	13.6 (10.4; 17.5)	=0.0003
Number of patients visiting the ED (for any reason) (%)	799 (11.17%)	1,415 (14.12%)	<0.0001	60 (4.20%)	823 (8.21%)	<0.0001
Number of ED visits	1,069	1,976		77	1,035
Adjusted incidence rate of ED visits/1,000 patient-years, m (95% CI)	131.9 (124.1; 140.0)	164.2 (157.0; 171.6)	<0.0001	132.6 (104.6; 165.6)	235.0 (220.9; 249.8)	<0.0001

Abbreviations: EGB, Echantillon Généraliste des Bénéficiaires; DPP4-i, dipeptidyl peptidase 4 inhibitors; IS, insulin secretagogues; ED, emergency department; IS, insulin secretagogues (sulfonylurea or glinide); m, mean.

Table 4 Adjusted comparison of the frequency of events in the EGB cohorts (whole DPP4-i class, vildagliptin, IS), considering only treatment initiations in the IS cohort

	DPP4-i N=6,701	IS initiation N=4,005	P-value	Vildagliptin	IS initiation N=4,005	P-value N=1,440
Person-years of exposure	7,062	6,232		581	1,704
Number of patients admitted to hospital for hypoglycemia (%)	8 (0.12%)	17 (0.42%)	=0.0016	0 (0.0%)	14 (0.35%)	=0.025
Number of hospital admissions for hypoglycemia	11	18		0	14
Adjusted incidence rate of hospital admissions for hypoglycemia/1,000 patient-years, m (95% CI)	1.6 (0.8; 2.8)	2.9 (1.7; 4.6)	=0.1068	0.0 (0.0; 0.0)	8.2 (4.5; 13.8)	=0.01
Number of patients visiting the ED (for any reason) (%)	704 (10.51%)	666 (16.63%)	<0.0001	60 (4.20%)	317 (7.90%)	<0.0001
Number of ED visits	937	960		77	410
Adjusted incidence rate of ED visits/1,000 patient-years, m (95% CI)	132.7 (124.3; 141.5)	154.0 (144.5; 164.1)	=0.0012	132.6 (104.6; 165.6)	240.6 (217.9; 265.1)	<0.0001

Abbreviations: ED, emergency department; IS, insulin secretagogues (sulfonylurea or glinide); EGB, Echantillon Généraliste des Bénéficiaires; DPP4-i, dipeptidyl peptidase 4 inhibitors; m, mean.