{"doi":"10.2337/dc23-1189","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","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.","journal":"Diabetes Care","year":2023,"id":354499,"datarank":0.3440910418673289,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.03217481061535349,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.03217481061535349,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":6,"citers_with_citation_signal":2,"citers_with_endowment":2,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8822,"is_data_producer":true,"deposit_databanks":{"figshare":["10.2337/figshare.24534934"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1101663,"name":"Shuping Huang","orcid":"0000-0002-2286-5182","position":1,"is_corresponding":false},{"id":1101664,"name":"Chien‐Chou Su","orcid":"0000-0001-5046-125X","position":2,"is_corresponding":false},{"id":998511,"name":"David Robinson","orcid":"0000-0002-6615-6054","position":3,"is_corresponding":false},{"id":1102056,"name":"John Read","orcid":null,"position":4,"is_corresponding":false},{"id":1101665,"name":"Chuan‐Yao Lin","orcid":"0000-0002-0005-7088","position":5,"is_corresponding":false},{"id":106068,"name":"Rachel C. Nethery","orcid":"0000-0001-9895-1477","position":6,"is_corresponding":false},{"id":627623,"name":"Kevin Josey","orcid":"0000-0003-2490-6272","position":7,"is_corresponding":false},{"id":1101666,"name":"Poonam Gandhi","orcid":"0000-0003-0939-829X","position":8,"is_corresponding":false},{"id":915741,"name":"Benjamin R. Bates","orcid":"0000-0001-5948-1396","position":9,"is_corresponding":false},{"id":998510,"name":"Melanie Rua","orcid":"0000-0001-8597-6392","position":10,"is_corresponding":false},{"id":1102057,"name":"Ashwagosha Parthasarathi","orcid":null,"position":11,"is_corresponding":false},{"id":949159,"name":"Arnab K. Ghosh","orcid":"0000-0002-5887-3301","position":12,"is_corresponding":false},{"id":1101667,"name":"Yea‐Huei Kao Yang","orcid":"0000-0003-4623-5561","position":13,"is_corresponding":false},{"id":281090,"name":"Soko Setoguchi","orcid":"0000-0002-1583-752X","position":14,"is_corresponding":false},{"id":998509,"name":"Aayush Visaria","orcid":"0000-0002-2170-212X","position":0,"is_corresponding":true}],"reference_count":12,"raw_metadata":null,"created_at":"2026-07-19T01:13:06.959762Z","pmid":"38060348","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}