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Economic burden of hypoglycemia in patients with Type 2 diabetes Expert Rev. Pharmacoeconomics Outcomes Res. 12(1), 47–51 (2012)

Shuqian Liu1, Yingnan Zhao1, James M Hempe2, Vivian Fonseca3 and Lizheng Shi*1,3 School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, New Orleans, LA 70112, USA 2 Research Institute for Children, Children’s Hospital New Orleans, 200 Henry Clay Avenue, New Orleans, LA 70118, USA 3 School of Medicine, Tulane University, 1430 Tulane Avenue, New Orleans, LA 70112, USA *Author for correspondence: Tel.: +1 504 988 6548 Fax: +1 504 988 3783 [email protected] 1

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Hypoglycemia is an acute complication of diabetes that increases morbidity, mortality and economic costs of diabetes. It presents major clinical problems for the management of Type 2 diabetes as this disease represents the great majority of all diabetes cases. Hypoglycemia makes it difficult for some individuals to achieve good glycemic control, reduces quality of life and increases the burden of diabetes to healthcare systems. Understanding hypoglycemia risk factors can help patients with Type 2 diabetes to correct and avoid hypoglycemia. Recently, an increased risk of hypoglycemia with intensive glycemic control has been identified as an important problem in optimally controlling blood glucose levels in patients with Type 2 diabetes. Keywords : economic burden • glucose control • hypoglycemia • insulin • Type 2 diabetes mellitus

Diabetes and its acute and chronic complications are significant causes of morbidity and mortality in the USA. It is now well established that intensive glycemic control reduces the risk of diabetic microvascular complications in both Type 1 and 2 diabetes  [1–4] . It may also reduce the risk of macrovascular events  [2,5–7] . However, the use of intensive glycemic management regimens to achieve glycated hemoglobin (A1C)