| Title | Ambient Heat and Risk of Serious Hypoglycemia in Older Adults With Diabetes Using Insulin in the U.S. and Taiwan: A Cross-National Case-Crossover Study. |
| Publication Type | Journal Article |
| Year of Publication | 2024 |
| Authors | Visaria A, Huang S-P, Su C-C, Robinson D, Read J, Lin C-Y, Nethery R, Josey K, Gandhi P, Bates B, Rua M, Parthasarathi A, Ghosh AK, Yang Y-HKao, Setoguchi S |
| Journal | Diabetes Care |
| Volume | 47 |
| Issue | 2 |
| Pagination | 233-238 |
| Date Published | 2024 Feb 01 |
| ISSN | 1935-5548 |
| Keywords | Aged, Cross-Over Studies, Diabetes Mellitus, Hot Temperature, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Insulin, Regular, Human, Medicare, Retrospective Studies, Taiwan, United States |
| Abstract | 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. |
| DOI | 10.2337/dc23-1189 |
| Alternate Journal | Diabetes Care |
| PubMed ID | 38060348 |
| PubMed Central ID | PMC10834387 |
| Grant List | K08 HL163329 / HL / NHLBI NIH HHS / United States P30 ES005022 / ES / NIEHS NIH HHS / United States R01 AG060232 / AG / NIA NIH HHS / United States #1R01AG060232-01A1 / AG / NIA NIH HHS / United States |