Abstract
Recently, oral hypoglycemic agents with newer glucose lowering mechanisms have
been on release. This is mostly to meet the diabetic patient’s need to
avoid hypoglycemia, which is profoundly important for better long-term outcome
of the treatment. In this study, we quantified the annual number of patients
with type 2 diabetes who experienced hypoglycemia needing the third-party
assistance who had random sample plasma
glucose<59.4 mg/dl (3.3 mmol/l) on the
one hand and analyzed the prescription trend of hypoglycemic agents all over
Japan on the other. Analysis of the annual number of hypoglycemic patients
visited ER was performed at Aizawa Hospital, a medical center located in the
midst of a city. The study duration was over 10 years from 2008 to 2019. We
found a clear-cut decreasing trend of hypoglycemia over the 10 years, ca.
61/year to 39/year. Immediately after the release of
sodium-glucose co-transporter-2 inhibitors, since 2013 to 2017, the decrease was
rather sharp as 81/year to 31/year, and the change of the
national number of its prescription inversely correlated with the change of the
number of the patients with hypoglycemia. This was not the case immediately
after the introduction of dipeptidyl peptidase-4 inhibitors in the Japanese
market since 2008 to 2012. There was no significant correlation between its
prescription and the number of patients with hypoglycemia. The data strongly
suggested that there was a causal relationship exclusively between the
introduction of sodium-glucose cotransporter-2 inhibitor, and the reduction of
hypoglycemic events among patients with type 2 diabetes.
Key words
etiology - adverse effects - complications
