Abstract #1089725: Type 2 Diabetes Mellitus Patients: Comprehension of Hypoglycemia: A Long and Winding Road to Optimal Care of Diabetes

Abstract

Hypoglycemia is an acute and significant treatment-related complication of diabetes. Neuroglycopenic manifestations of hypoglycemia range from mild to lethal symptoms that can compromise patient safety and are potentially deadly. Recent study showed that rate of severe hypoglycemia history among type 2 diabetes mellitus (T2DM) outpatient in tertiary referral hospital was 34%. Multiple patient-specific factors affect hypoglycemia risk, including patients’ comprehension of hypoglycemia symptoms and signs. Our study aims to examine patients’ comprehension of hypoglycemia and its associated factors among T2DM patients. This cross-sectional study was using data from a study reporting rate of severe hypoglycemia, which was conducted in endocrinology outpatient clinic of Cipto Mangunkusumo hospital, Jakarta, Indonesia. Patients’ comprehension of hypoglycemia was defined as patients’ ability to define cut-off value of hypoglycemia and mention at least three neuroglycopenic symptoms of hypoglycemia. Chi-square test and Mann-Whitney U test were implemented to analyze the association and difference between independent and dependent variables. Out of 291 patients, 62.9% were woman. All subjects had mean of age 59.9 (9.36) years old; median of HbA1c 7.5% (5.1-14.3), median of diabetes duration 12 (1-43) years. There was only 63 (21.7%) patients who had comprehension of hypoglycemia symptoms and signs. Patients in the group of age > 60 years old (OR 0.45; p = 0.006; 95% CI 0.25,0.80), HbA1c ≤ 7.5% (OR 0.53; p=0.026; 95% CI 0.30,0.93), education level ≤ 9 years (OR 0.39; p=0.013; 95% CI 0.18,0.84) and using sulfonylurea only (OR 0.49; p=0.025; 95% CI 0.27,0.92), were less likely to have comprehension of hypoglycemia. We found no association between diabetes duration and comprehension of hypoglycemia. Proportion of comprehending patients regarding hypoglycemia was still low. Older age, lower education level, poorer glycemic control, and use of sulfonylurea are associated factors of patients’ comprehension of hypoglycemia. Our findings suggested that there was lack of education effectiveness in the continuum care of the patients. Further studies are needed to evaluate the needs of a better education structure for the T2DM patients.