PDB57 - THE IMPACT OF HYPOGLYCAEMIA ON PATIENT ACTIONS AND QUALITY OF LIFE IN 5 EUROPEAN COUNTRIES

Abstract

To examine the impact of hypoglycaemia and patient actions on psychosocial well-being in 5 European countries (Austria, Denmark, Finland, the Netherlands and Sweden) in a non-interventional observational study. HAT (Hypoglycaemia Assessment Tool) is a large international multicenter, 6-month retrospective and 1-month prospective study of hypoglycaemic events. Questionnaires and patient diaries (1-month prospective period) were completed by adults with type 1 (T1DM) or type 2 diabetes mellitus (T2DM) using insulin for ≥12 months (n=3,337). Patient actions due to hypoglycaemia (such as increased blood glucose self-monitoring (BGM)) were quantified over time. Predictors of a decreased psychosocial well-being (WHO well-being index <13) were analyzed in multi-adjusted logistic regression analysis for the pooled cohort of the 5 countries. More frequent BGM was the major patient response to hypoglycaemia that had a direct economic impact. Overall, 60.3% T1DM and 58.8% T2DM patients increased BGMs following a hypoglycaemic event. Among these T1DM patients 42.8% increased BGMs with 2 extra daily measurements for on average 5 days. Likewise, 45.8% of the T2DM patient that increased BGMs had 2 extra daily measurements for on average 4 days as a consequence of hypoglycaemia. Women were prone to a decreased psychosocial well-being compared with men (odds ratio (OR)=1.59; confidence interval (CI)=1.31-1.94). Severe hypoglycaemic event (OR=1.30; CI=0.97-1.74) and the subsequent fear of hypoglycaemia (OR=1.11; CI=1.07-1.14) were associated with decreased psychosocial well-being. T2DM patients had the double risk for decreased psychosocial well-being compared with T1DM patients (OR=2.13; CI=1.53-2.96). Duration of diabetes and insulin therapy, non-severe hypoglycaemic events, HbA1c and knowledge of hypoglycaemia were not associated with psychosocial well-being. The burden of hypoglycaemic events has a long-term negative impact on patient actions and decreases psychosocial well-being resulting in a significant economic impact on the diabetes healthcare.