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Ambient Heat and Risk of Serious Hypoglycemia in Older Adults With Diabetes Using Insulin in the U.S. and Taiwan: A
Aayush Visaria1, Shu-Ping Huang2,3, Chien-Chou Su3,4
1Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
Objective:
To measure the association between ambient heat and hypoglycemia-related emergency department visit or hospitalization in insulin users.
Research Design And Methods:
We identified cases of serious hypoglycemia among adults using insulin aged ≥65 in the U.S. (via Medicare Part A/B/D-eligible beneficiaries) and Taiwan (via National Health Insurance Database) from June to September, 2016-2019. We then estimated odds of hypoglycemia by heat index (HI) percentile categories using conditional logistic regression with a time-stratified case-crossover design.
Results:
Among ∼2 million insulin users in the U.S. (32,461 hypoglycemia case subjects), odds ratios of hypoglycemia for HI >99th, 95-98th, 85-94th, and 75-84th percentiles compared with the 25-74th percentile were 1.38 (95% CI, 1.28-1.48), 1.14 (1.08-1.20), 1.12 (1.08-1.17), and 1.09 (1.04-1.13) respectively. Overall patterns of associations were similar for insulin users in the Taiwan sample (∼283,000 insulin users, 10,162 hypoglycemia case subjects).
Conclusions:
In two national samples of older insulin users, higher ambient temperature was associated with increased hypoglycemia risk.
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