{"id":"https://openalex.org/W2917622816","doi":"https://doi.org/10.1080/03007995.2017.1391079","title":"The burden of severe hypoglycemia in type 1 diabetes","display_name":"The burden of severe hypoglycemia in type 1 diabetes","publication_year":2017,"publication_date":"2017-10-11","ids":{"openalex":"https://openalex.org/W2917622816","doi":"https://doi.org/10.1080/03007995.2017.1391079","mag":"2917622816","pmid":"https://pubmed.ncbi.nlm.nih.gov/29019269"},"language":"en","primary_location":{"id":"doi:10.1080/03007995.2017.1391079","doi":"https://doi.org/10.1080/03007995.2017.1391079","is_oa":false,"landing_page_url":"https://doi.org/10.1080/03007995.2017.1391079","pdf_url":null,"source":{"id":"https://openalex.org/S206643269","display_name":"Current Medical Research and Opinion","issn_l":"0300-7995","issn":["0300-7995","1473-4877"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320547","host_organization_name":"Taylor & Francis","host_organization_lineage":["https://openalex.org/P4310320547","https://openalex.org/P4310320449"],"host_organization_lineage_names":["Taylor & Francis","Informa"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Current Medical Research and Opinion","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5018932857","display_name":"Jieruo Liu","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Jieruo Liu","raw_affiliation_strings":["Evidera, Waltham, MA, USA;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Evidera, Waltham, MA, USA;","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5061078791","display_name":"Rosa Wang","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Rosa Wang","raw_affiliation_strings":["Evidera, Waltham, MA, USA;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Evidera, Waltham, MA, USA;","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5047100651","display_name":"Michael Lee Ganz","orcid":"https://orcid.org/0000-0002-9702-2999","observed_orcids":["https://orcid.org/0000-0002-9702-2999"]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Michael L. Ganz","raw_affiliation_strings":["Evidera, Waltham, MA, USA;"],"raw_orcid":"https://orcid.org/0000-0002-9702-2999","affiliations":[{"raw_affiliation_string":"Evidera, Waltham, MA, USA;","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5013281261","display_name":"Yurek Paprocki","orcid":"https://orcid.org/0000-0002-5435-5179","observed_orcids":["https://orcid.org/0000-0002-5435-5179"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Yurek Paprocki","raw_affiliation_strings":["Novo Nordisk Inc., Plainsboro, NJ, USA;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Novo Nordisk Inc., Plainsboro, NJ, USA;","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5016242440","display_name":"Doron Schneider","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Doron Schneider","raw_affiliation_strings":["Abington Adult Medical Associates, Abington, PA, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Abington Adult Medical Associates, Abington, PA, USA","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5069596956","display_name":"James Weatherall","orcid":"https://orcid.org/0000-0002-2673-9538","observed_orcids":["https://orcid.org/0000-0002-2673-9538"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"James Weatherall","raw_affiliation_strings":["Novo Nordisk Inc., Plainsboro, NJ, USA;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Novo Nordisk Inc., Plainsboro, NJ, USA;","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":["https://openalex.org/A5047100651"],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":3.8881,"has_fulltext":false,"cited_by_count":44,"citation_normalized_percentile":{"value":0.94688364,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":93,"max":99},"biblio":{"volume":"34","issue":"1","first_page":"171","last_page":"177"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10560","display_name":"Diabetes Management and Research","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10560","display_name":"Diabetes Management and Research","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10793","display_name":"Diabetes Management and Education","score":0.0005000000237487257,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10401","display_name":"Diabetes Treatment and Management","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/severe-hypoglycemia","display_name":"severe hypoglycemia","score":0.9890000224113464},{"id":"https://openalex.org/keywords/type-1-diabetes","display_name":"type 1 diabetes","score":0.9639999866485596},{"id":"https://openalex.org/keywords/multiple-daily-injections","display_name":"multiple daily insulin injections","score":0.9039999842643738},{"id":"https://openalex.org/keywords/hospitalization-costs","display_name":"hospital costs","score":0.7770000100135803},{"id":"https://openalex.org/keywords/emergency-department-visits","display_name":"emergency department visits","score":0.8949999809265137},{"id":"https://openalex.org/keywords/insulin-adherence","display_name":"insulin adherence","score":0.6179999709129333},{"id":"https://openalex.org/keywords/length-of-hospital-stay","display_name":"length of hospital stay","score":0.5879999995231628},{"id":"https://openalex.org/keywords/hospital-readmission","display_name":"hospital readmission","score":0.5379999876022339},{"id":"https://openalex.org/keywords/economic-burden","display_name":"economic burden","score":0.35899999737739563},{"id":"https://openalex.org/keywords/propensity-score-matching","display_name":"propensity score matching","score":0.3840000033378601},{"id":"https://openalex.org/keywords/inverse-probability-weighting","display_name":"inverse probability weighting","score":0.9860000014305115}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9759871363639832},{"id":"https://openalex.org/C2780668416","wikidata":"https://www.wikidata.org/wiki/Q202758","display_name":"Hypoglycemia","level":3,"score":0.719520092010498},{"id":"https://openalex.org/C2780724011","wikidata":"https://www.wikidata.org/wiki/Q1295316","display_name":"Emergency department","level":2,"score":0.7161744236946106},{"id":"https://openalex.org/C555293320","wikidata":"https://www.wikidata.org/wiki/Q12206","display_name":"Diabetes mellitus","level":2,"score":0.6094892024993896},{"id":"https://openalex.org/C17923572","wikidata":"https://www.wikidata.org/wiki/Q7250160","display_name":"Propensity score matching","level":2,"score":0.5741520524024963},{"id":"https://openalex.org/C2779306644","wikidata":"https://www.wikidata.org/wiki/Q2002370","display_name":"Insulin","level":2,"score":0.5493618249893188},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.5393990874290466},{"id":"https://openalex.org/C2777180221","wikidata":"https://www.wikidata.org/wiki/Q3025883","display_name":"Type 2 diabetes","level":3,"score":0.46637633442878723},{"id":"https://openalex.org/C2781232474","wikidata":"https://www.wikidata.org/wiki/Q124407","display_name":"Type 1 diabetes","level":3,"score":0.4523736238479614},{"id":"https://openalex.org/C3020110884","wikidata":"https://www.wikidata.org/wiki/Q695416","display_name":"Outpatient clinic","level":2,"score":0.43238192796707153},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.37369704246520996},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.36265528202056885},{"id":"https://openalex.org/C134018914","wikidata":"https://www.wikidata.org/wiki/Q162606","display_name":"Endocrinology","level":1,"score":0.08882096409797668},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D000293","descriptor_name":"Adolescent","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000368","descriptor_name":"Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003365","descriptor_name":"Costs and Cost Analysis","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003922","descriptor_name":"Diabetes Mellitus, Type 1","qualifier_ui":"Q000188","qualifier_name":"drug therapy","is_major_topic":true},{"descriptor_ui":"D004636","descriptor_name":"Emergency Service, Hospital","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006760","descriptor_name":"Hospitalization","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007003","descriptor_name":"Hypoglycemia","qualifier_ui":"Q000139","qualifier_name":"chemically induced","is_major_topic":false},{"descriptor_ui":"D007003","descriptor_name":"Hypoglycemia","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":true},{"descriptor_ui":"D007004","descriptor_name":"Hypoglycemic Agents","qualifier_ui":"Q000008","qualifier_name":"administration & dosage","is_major_topic":true},{"descriptor_ui":"D007004","descriptor_name":"Hypoglycemic Agents","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D007328","descriptor_name":"Insulin","qualifier_ui":"Q000008","qualifier_name":"administration & dosage","is_major_topic":true},{"descriptor_ui":"D007328","descriptor_name":"Insulin","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D055815","descriptor_name":"Young Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1080/03007995.2017.1391079","doi":"https://doi.org/10.1080/03007995.2017.1391079","is_oa":false,"landing_page_url":"https://doi.org/10.1080/03007995.2017.1391079","pdf_url":null,"source":{"id":"https://openalex.org/S206643269","display_name":"Current Medical Research and Opinion","issn_l":"0300-7995","issn":["0300-7995","1473-4877"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320547","host_organization_name":"Taylor & Francis","host_organization_lineage":["https://openalex.org/P4310320547","https://openalex.org/P4310320449"],"host_organization_lineage_names":["Taylor & Francis","Informa"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Current Medical Research and Opinion","raw_type":"journal-article"},{"id":"pmid:29019269","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/29019269","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Current medical research and opinion","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":22,"referenced_works":["https://openalex.org/W1494818682","https://openalex.org/W1842840699","https://openalex.org/W1911582143","https://openalex.org/W1916643951","https://openalex.org/W1950637443","https://openalex.org/W1971329074","https://openalex.org/W2002529638","https://openalex.org/W2004910803","https://openalex.org/W2026020974","https://openalex.org/W2048981123","https://openalex.org/W2066059923","https://openalex.org/W2114417910","https://openalex.org/W2135984579","https://openalex.org/W2141474943","https://openalex.org/W2146037932","https://openalex.org/W2147999853","https://openalex.org/W2162257275","https://openalex.org/W2167520440","https://openalex.org/W2274212682","https://openalex.org/W2278939565","https://openalex.org/W2338239184","https://openalex.org/W4229629337"],"related_works":["https://openalex.org/W2761000676","https://openalex.org/W7130694350","https://openalex.org/W2338239184","https://openalex.org/W2899631300","https://openalex.org/W2026020974","https://openalex.org/W2911926283","https://openalex.org/W2136241701","https://openalex.org/W2551825717","https://openalex.org/W2982539048","https://openalex.org/W2560580247"],"abstract_inverted_index":{"AIMS:":[0],"Approximately":[1,215],"1.25":[2],"million":[3],"people":[4],"in":[5,47,191,209,232,240,245,254,280,396],"the":[6,21,63,163,192,210,223,225,233,241,246,281,380,415],"US":[7],"have":[8,321],"type":[9],"1":[10],"diabetes":[11],"mellitus":[12],"(T1DM),":[13],"a":[14],"chronic":[15],"metabolic":[16],"disease":[17],"that":[18],"develops":[19],"from":[20],"body's":[22],"inability":[23],"to":[24,41,61,157,165,222,291,329,372],"produce":[25],"insulin,":[26],"and":[27,43,54,65,70,127,141,147,150,194,251,288,324,341],"requires":[28],"life-long":[29],"insulin":[30,33,94,339,364],"therapy.":[31],"Poor":[32],"adherence":[34],"may":[35,320],"cause":[36],"severe":[37],"hypoglycemia":[38],"(SHO),":[39],"leading":[40],"hospitalization":[42,123,143,277,402],"long-term":[44],"complications;":[45],"these,":[46],"turn,":[48],"drive":[49],"up":[50],"costs":[51,66,144,272,297,381,397],"of":[52,67,139,174,189,217,258,343,359,382],"SHO":[53,100,102,125,187,196,237,266,300,353,384,405,410,419],"T1DM":[55,78,90,360],"overall.":[56],"This":[57],"study's":[58],"objective":[59],"was":[60],"estimate":[62],"prevalence":[64],"SHO-related":[68,114,142,181,203,276],"hospitalizations":[69],"their":[71,274,383,401],"additional":[72],"longer-term":[73,167],"impacts":[74],"on":[75],"patients":[76,91,218,238,259,267,279,306,361,378,421],"with":[77,112,129,317,335,352,418,422],"using":[79,92,362],"basal-bolus":[80,93,363],"insulin.":[81],"METHODS:":[82],"Using":[83],"Truven":[84],"MarketScan":[85],"claims,":[86],"we":[87,325],"identified":[88,171],"adult":[89],"regimens":[95,365],"who":[96,185,307],"were":[97,109,145,155,207,219,227,260,326],"hospitalized":[98,261,367],"for":[99,159,248,263,298,331],"(inpatient":[101],"patients)":[103],"during":[104],"2010-2015.":[105],"Two":[106],"comparison":[107,407],"groups":[108,164,284],"defined:":[110],"those":[111,128,184,190,377],"outpatient":[113,195,404],"encounters":[115],"only,":[116],"including":[117,243],"emergency":[118],"department":[119],"(ED)":[120],"visits":[121],"without":[122,212],"(outpatient":[124],"patients),":[126],"no":[130],"SHO-":[131],"or":[132,230,293,312,345,406],"acute":[133],"hyperglycemia-related":[134],"events":[135,319,411],"(comparison":[136],"patients).":[137],"Lengths":[138],"stay":[140],"estimated":[146],"propensity":[148],"score":[149],"inverse":[151],"probability":[152],"weighting":[153],"methods":[154],"used":[156],"adjust":[158],"baseline":[160],"differences":[161],"across":[162],"evaluate":[166],"impacts.":[168],"RESULTS:":[169],"We":[170],"8,734":[172],"patients,":[173],"which":[175],"4.2%":[176],"experienced":[177,186,199],"at":[178,200,368,391],"least":[179,201,369,392],"one":[180,202],"hospitalization.":[182,214],"Among":[183],"(i.e.":[188],"inpatient":[193,236,299],"groups),":[197],"31%":[198],"hospitalization,":[204,385],"while":[205],"9%":[206],"treated":[208,231],"ED":[211,311],"subsequent":[213],"79%":[216],"admitted":[220],"directly":[221],"hospital;":[224],"remainder":[226],"first":[228],"assessed":[229],"ED.":[234],"The":[235,349],"stayed":[239],"hospital,":[242],"time":[244],"ED,":[247],"1.7":[249],"days":[250],"incurred":[252,268],"$3551":[253],"costs.":[255],"About":[256,357],"one-third":[257],"again":[262],"SHO.":[264,373],"Inpatient":[265],"significantly":[269],"higher":[270,295],"monthly":[271,296],"after":[273,400],"initial":[275],"than":[278,403],"two":[282],"other":[283],"($2084":[285],"vs":[286],"$1313":[287],"$1372),":[289],"corresponding":[290],"59%":[292],"52%":[294],"patients.":[301,408],"LIMITATIONS:":[302],"These":[303],"analyses":[304],"excluded":[305],"did":[308,376],"not":[309,327,355],"seek":[310],"hospital":[313],"care":[314],"when":[315],"faced":[316],"SHO;":[318],"been":[322],"miscoded;":[323],"able":[328],"account":[330],"clinical":[332],"characteristics":[333],"associated":[334,351,417],"SHO,":[336],"such":[337],"as":[338],"dose":[340],"duration":[342],"diabetes,":[344],"unmeasured":[346],"confounders.":[347],"CONCLUSIONS:":[348],"burden":[350,416],"is":[354],"negligible.":[356],"4%":[358],"are":[366],"once":[370],"due":[371],"Not":[374],"only":[375],"incur":[379,389],"but":[386],"they":[387],"also":[388],"red":[390],"$712":[393],"(52%)":[394],"more":[395],"per":[398],"month":[399],"Reducing":[409],"can":[412],"help":[413],"decrease":[414],"among":[420],"T1DM.":[423]},"counts_by_year":[{"year":2026,"cited_by_count":4},{"year":2025,"cited_by_count":5},{"year":2024,"cited_by_count":3},{"year":2023,"cited_by_count":2},{"year":2022,"cited_by_count":7},{"year":2021,"cited_by_count":5},{"year":2020,"cited_by_count":8},{"year":2019,"cited_by_count":7},{"year":2018,"cited_by_count":3}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2019-03-02T00:00:00"}