On July 19, 2013, new study results presented by members of the Centers for Disease and Control and Prevention (CDC) showed that elderly patients with diabetes exhibited higher rates of adverse events and emergency department (ED) visits compared to younger patients. Findings stated that patients 80 years of age or older were 2.5 times more likely to seek ED care for insulin-related adverse events, and almost 5 times more likely to be hospitalized for those adverse events.
Findings were presented at the annual American Diabetes Association’s Scientific Sessions by Dr. Andrew I. Geller of the CDC. Rates of insulin use were analyzed using data from the National Health Interview Survey, while insulin-related adverse effects were calculated from National Electronic Injury Surveillance System–Cooperative Adverse Drug Event Surveillance (NEISS-CADES) records. Included in the analysis were adverse events associated with higher than recommended therapeutic doses of medication (e.g. low blood sugar) and medication administration errors.
Between 2007 and 2011, investigators estimated that there were 97,745 ED visits due to insulin-related adverse events. Compared to other age groups, patients 80 years and older had higher rates of ED visits and hospitalizations. Insulin adverse effects were most commonly attributed to meal-related factors, product mix-ups, and incorrect dose administration. Investigators concluded that different medication guidelines may be beneficial for some older adults with diabetes.
Insulin (Apidra, Humalog, Humalog Mix, Humulin, Lantus, Levemir, Novolin, Novolog, Novolog Mix) is a class of medications used to treat diabetes. Insulin is a hormone that works by lowering blood sugar as it regulates metabolism of carbohydrates and fats in the body. There is both long-acting and short- acting insulin available. Patients with diabetes require insulin because either their body does not produce adequate amounts of the hormone (type I) or their body is insulin-resistant and the hormone does not evoke a response from their cells (type II).
Using FAERS data (from 11/01/1997 to 08/27/2012), aggregated and standardized by the AdverseEvent RxFilter process, we identified 58,805 serious adverse events between 2007 and 2011 which listed insulin as a suspect drug. Of these reports, 21,817 listed insulin as the primary suspect.
We identified 2,595 cases of hypoglycemia (low blood pressure) and 265 cases of medication error. We identified 7,707 hospitalizations and 1,407 patient deaths where insulin was indicated as the primary suspect. There were 1,407 primary suspect case reports for patients listed as 80 years or older, 1,353 cases of which included hospitalizations.
Note: This analysis does not take into account the number of patients taking each medication.