Abstract
BackgroundHypoglycemia affects patient safety and glycemic control during insulin treatment of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). The Hypoglycemia Assessment Tool study in Brazil aimed to determine the proportion of patients experiencing hypoglycemic events and to characterize patient awareness and fear about hypoglycemia, among insulin-treated T1DM or T2DM patients.MethodsThis was a non-interventional, multicenter study, with a 6-month retrospective and a 4-week prospective evaluation of hypoglycemic events. Patients completed a questionnaire at baseline and at the end of the study, and also a patient diary. The answers ‘occasionally’ and ‘never’ to the question ‘Do you have symptoms when you have a low sugar level?’ denoted impaired hypoglycemia awareness. Fear was reported on a 10-point scale, from ‘not afraid at all’ to ‘absolutely terrified’.ResultsFrom 679 included patients, 321 with T1DM and 293 T2DM, median age of 33.0 and 62.0 years, 59% and 56% were female, and median diabetes duration was 15.0 and 15.0 years, respectively. Median time of insulin use was 14.0 and 6.0 years. During the prospective period, 91.7% T1DM and 61.8% T2DM patients had at least one hypoglycemic event. In the same period, 54.0% T1DM and 27.4% T2DM patients had nocturnal hypoglycemia, 20.6% T1DM and 10.6% T2DM patients had asymptomatic hypoglycemia, and severe events occurred in 20.0% and 10.3%, respectively. At baseline, 21.4% T1DM and 34.3% T2DM had hypoglycemia unawareness. The mean score of hypoglycemia fear was 5.9 ± 3.1 in T1DM and 5.4 ± 3.9 in T2DM. The most common attitude after hypoglycemic events were to increase calorie intake (60.3%) and blood glucose monitoring (58.0%) and to reduce or skip insulin doses (30.8%).ConclusionsReferred episodes of hypoglycemia were high, in both T1DM and T2DM insulin users. Patient attitudes after hypoglycemia, such as reduction in insulin and increase in calorie intake, can affect diabetes management. These findings may support clinicians in tailoring diabetes education and insulin treatment for patients with diabetes, in order to improve their glycemic control while reducing the risk of hypoglycemic events.
Highlights
Hypoglycemia affects patient safety and glycemic control during insulin treatment of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM)
Patients with type 1 diabetes mellitus (T1DM) were younger than those with T2DM and more T1DM patients were full-time employees (45.5% vs. 21.2%). Both T1DM and T2DM patients had a similar duration of diabetes but T1DM patients had a longer duration of insulin use (median of Female sex, n (%) Age, median [lower quartile (Q1), upper quartile (Q3)] Full-time employment, n (%) Duration of diabetes, median [Q1, Q3] Last measured glycated hemoglobin (HbA1c) value (%), median [Q1, Q3] Checks blood sugar levels, n (%) Has ever experienced hypoglycemia, n (%) Patients identifying hypoglycemia based on, n (%)
Among T1DM patients that had a previous experience of hypoglycemia (n = 313), 42.6% identified hypoglycemic events by both symptoms and blood glucose measurement
Summary
Hypoglycemia affects patient safety and glycemic control during insulin treatment of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Optimizing blood glucose control is demanding, since it requires balancing the need for glycemic control with the risk of hypoglycemia [2,3,4]. The risk of hypoglycemia is a barrier to optimal treatment of type 1 diabetes (T1DM) and type 2 diabetes (T2DM), especially within the context of insulin therapy [5]. Recurrent asymptomatic episodes characterizes hypoglycemia unawareness, which has been shown to increase the risk of severe hypoglycemic episodes [6, 9]. Patient fear of hypoglycemia is frequent and may affect treatment adherence and, glycemic control [6, 10]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.