Abstract

AimsThe purpose of this study was to explore the burden and impact of non-severe nocturnal hypoglycaemic events (NSNHEs) on diabetes management, patient functioning and well-being in order to better understand the role that NSNHEs play in caring for persons with diabetes and facilitate optimal diabetes treatment management strategies.MethodsA 20-min survey assessing the impact of NSNHEs was administered to patients with self-reported diabetes age 18 or older via the Internet in nine countries (USA, UK, Germany, Canada, France, Italy, Spain, The Netherlands and Sweden) who experienced an NSNHE in the last month. Questions captured reasons for and length of the event, and impacts on diabetes management, daily function, sleep and well-being.ResultsA total of 20 212 persons with Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM) were screened of which 2108 respondents were eligible. Respondents initiated, on average, an additional 3.6 glucose monitoring tests, and did not resume usual functioning for an average of 3.4 hours after the NSNHE. Of the respondents using insulin, 15.8% decreased their insulin dose over an average of 3.6 days. NSNHEs also impacted sleep, with 10.4% not returning to sleep that night. Next day functioning was affected with 60.3% (n = 1273) feeling the need to take a nap and/or rest (with 65.5% of those actually taking a nap/rest) and 40.2% (n = 848) wanting to go to bed earlier than usual. A total of 21.4% were restricted in their driving the next day. These events also resulted in decreased well-being with 39.6% of respondents feeling ‘emotional low’ the following day.ConclusionsNSNHEs have serious consequences for patients. Greater attention to patient and physician education regarding the burden of NSNHEs and incorporation of corrective actions in treatment plans is needed to facilitate patients reaching optimal glycaemic control.

Highlights

  • Non-severe hypoglycaemic events are not uncommon in both Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM) and may occur in approximately one third of persons with diabetes with frequency of events as often as several times a week [1]

  • Data from multiple studies indicate that non-severe hypoglycaemic events occur in approximately 24–60% of patients with diabetes [7,8,9,10,11] and can occur at any time of day or night while patients are at rest or engaged in activities. Both qualitative and quantitative research have found that non-severe nocturnal hypoglycaemic events (NSNHEs), occurring while patients are sleeping, create more fear and anxiety for patients than daytime events and have been found to result in greater work loss productivity than events that occur at work [1,7,12]

  • The purpose of this study is to quantitatively explore, in greater depth than has previously been done, the burden and impact of these NSNHEs on diabetes management, patient functioning and well-being in order to better understand the role that NSNHEs play in caring for persons with diabetes and facilitate optimal diabetes treatment management strategies

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Summary

Introduction

Non-severe hypoglycaemic events are not uncommon in both Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM) and may occur in approximately one third of persons with diabetes with frequency of events as often as several times a week [1]. Data from multiple studies indicate that non-severe hypoglycaemic events occur in approximately 24–60% of patients with diabetes [7,8,9,10,11] and can occur at any time of day or night while patients are at rest or engaged in activities. Both qualitative and quantitative research have found that non-severe nocturnal hypoglycaemic events (NSNHEs), occurring while patients are sleeping, create more fear and anxiety for patients than daytime events and have been found to result in greater work loss productivity than events that occur at work [1,7,12]. Previous research on NSNHEs have begun to suggest that these events are important barriers to achieving optimal glycaemic control and are not inconsequential contributors to increasing health care costs while reducing patient functioning and well-being

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