Hypoglycemia: Risk Factors, Fragmentation of Care and Mortality Across Chicago A Study of the Chicago HealthLNK Data Repository

Complications from Type 2 Diabetes Mellitus (DM) are rising, leading to over $240 billion in total estimated diabetes costs. (1, 2) Acute complications (hypoglycemia and diabetic ketoacidosis [DKA]) account for substantial DM acute care utilization; for example, an estimated 140,000 DKA hospitalizations in 2009 - a 40% increase from a decade earlier- resulted in estimated medical expenditures in excess of $2.4 billion. (3, 4) Chronic complications, such as nephropathy and retinopathy, are the leading causes of renal failure and blindness in the US. (5, 6) Our previous data from Chicago Health LNK Data Repository (Health LNK) demonstrate that 33.4% of DM patients with any admission for DKA also had the presence of a chronic complication, with increasing chronic complication rates with recurrent DKA. (7) Currently, little is known about the populations with such complications across a city. More data is needed to understand which patients with acute complications develop chronic complications, and what their socio-demographic, comorbid, and health care utilization patterns are. Knowledge of these factors will help identify those at high risk for chronic complications and gaps in current care, but could overall improve care and ultimately reduce costs. Our aim is to identify and validate risk factors associated with development of chronic complications (nephropathy, retinopathy) in Type 2 DM patients (pts) with a history of acute (DKA and hypoglycemia) complications, using electronic health records (EHR) from 2004-2015 from Health LNK.