Comparison of Hypoglycemia/Hyperglycemia-Related ER Visits in Type 2 Diabetic Patients Using Premixed 70/30 Penfill or Insulin Syringe

Abstract

Administration of premixed 70/30 insulin by penfill or using syringe leads to different blood sugar control levels. This can in turn cause diverse adverse events. This retrospective cohort study aimed to identify the association of hypoglycemia-related/hyperglycemia-related emergency room (ER) visits in patients using premixed 70/30 penfill compared to those using insulin syringe. Data were collected from electronical medical records in type 2 diabetic patients who received medical services during 1 January 2010 through 31 December 2021. Of these patients, 508 and 743 were prescribed with premixed 70/30 insulin penfill and insulin syringe, respectively. They were followed-up for 36 months. Multiple logistic regression was used to identify the factors associated with hypoglycemia-related/hyperglycemia-related ER visits. The results showed that patients using penfill and syringe had 3.3% and 6.2% hypoglycemia-related-related ER visits, respectively. Patients using penfill were less likely to have hypoglycemia-related ER visits than those using insulin syringe (aOR=0.428, 95%CI=0.24-0.77, p=0.05). Patients aged 65 and over were 3.497 folds to have hypoglycemia-related ER visits compared to the younger (aOR=3.497, 95%CI=2.03-6.03, p<0.05). In addition, patients with caregivers were less likely to have hyperglycemia-related ER visits than those without caregivers. In conclusion, administration of premixed 70/30 insulin by penfill had lower hypoglycemia-related ER visits than using syringe. Patients aged 65 and over should be carefully monitored.