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
Authors' conclusion
In two national samples of older insulin users, higher ambient temperature was associated with increased hypoglycemia risk.
Study context
- Population
- Adults aged ≥65 using insulin in the U.S. (Medicare Part A/B/D-eligible beneficiaries) and Taiwan (National Health Insurance Database), June to September, 2016–2019U.S
- Participants
- 32,461 adults
- Comparison
- Heat index (HI) percentile categories vs 25-74th percentile
- Outcome
- Hypoglycemia-related ED visit or hospitalization
Methodological detailscross-national, time-stratified case-crossover design, conditional logistic regression
- Cross-national
- Time-stratified case-crossover design
- Conditional logistic regression
Main finding
As reported in the abstract
Serious hypoglycemia (U.S.)
Each group vs HI 25-74th percentileOdds ratio (95% CI)
HI >99th percentile
1.38(1.28–1.48)
HI 95-98th percentile
1.14(1.08–1.20)
HI 85-94th percentile
1.12(1.08–1.17)
HI 75-84th percentile
1.09(1.04–1.13)
Further findings
Serious hypoglycemia (Taiwan)
- Overall patterns of associations similar to the U.S.
- ∼283,000 insulin users, 10,162 hypoglycemia case subjects
Original publication
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. Diabetes Care. Published 7 December 2023. doi:10.
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