Interventions aimed at improving patients' knowledge of medications possess the greatest potential clinical value in improving adherence with antihypertensive therapy. However, we identified several limitations of these studies, and advise future researchers to focus on using validated adherence measures, well-designed randomized controlled trials with relevant adherence and clinical outcomes, and guidelines on the appropriate design and analysis of adherence research.

ObjectiveVery few real-world studies have been conducted to assess the incidence of diabetes-related hypoglycemia. Moreover, there is a paucity of studies that have investigated hypoglycemia among people taking secretagogues as a monotherapy or in combination with insulin. Accordingly, our research team developed and validated the InHypo-DM Person with Diabetes Mellitus Questionnaire (InHypo-DMPQ) with the aim of capturing the real-world incidence of self-reported, symptomatic hypoglycemia. The questionnaire was administered online to a national sample of Canadians (≥18 years old) with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) treated with insulin and/or insulin secretagogues.Research design and methodsSelf-report data obtained from the InHypo-DMPQ were descriptively analyzed to ascertain the crude incidence proportions and annualized incidence densities (rates) of 30-day retrospective non-severe and 1-year retrospective severe hypoglycemia, including daytime and nocturnal events.ResultsA total of 552 people (T2DM: 83%; T1DM: 17%) completed the questionnaire. Over half (65.2%) of the total respondents reported experiencing at least one event (non-severe or severe) at an annualized crude incidence density of 35.1 events per person-year. The incidence proportion and rate of non-severe events were higher among people with T1DM versus T2DM (77% and 55.7 events per person-year vs 54% and 28.0 events per person-year). Severe hypoglycemia was reported by 41.8% of all respondents, at an average rate of 2.5 events per person-year.ConclusionsThe results of the InHypo-DMPQ, the largest real-world investigation of hypoglycemia epidemiology in Canada, suggest that the incidence of hypoglycemia among adults with diabetes taking insulin and/or insulin secretagogues is higher than previously thought.

Increasing epidemic proportions of overweight children in the United States presents formidable challenges for education and healthcare. Given the popularity and pervasiveness of video gaming culture in North American children, the perfect opportunity arises to investigate the potential of video games to promote healthful behaviour. Our objective was to systematically review the literature for possible benefits of active and educational video games targeting diet and physical activity in children. A review of English-language journal articles from 1998 to 2011 using EMBASE and PubMed was conducted. Thirty-four studies concerned with children, video games, physical, and/or nutritional outcomes were included. Results of these studies that showed some benefit (increased physical activity and nutritional knowledge as a result of gaming) demonstrate the possibility of video games to combat childhood obesity—looking beyond the stigma attached to gaming.

ffective glycemic control can forestall the onset and advancement of diabetes-related microand macrovascular complications (1,2). However, the use of certain antihyperglycemic medications, namely insulin and insulin secretagogues, to treat type 1 or type 2 diabetes can result in hypoglycemia, a clinical syndrome characterized by abnormally low blood glucose (1,2). Optimal diabetes management is thus a delicate balance between treating hyperglycemia and avoiding the immediate risk of hypoglycemia (3).Hypoglycemia can result in serious physical (4,5) and psychosocial (6-9) morbidity, and mortality (5,10-14).Neurogenic symptoms include tremor, palpitations, anxiety, sweating, pallor, and hunger, whereas neuroglycopenic symptoms include cognitive impairment, behavioral changes, psychomotor abnormalities, seizures, and coma (15). Hypoglycemia can affect both quality of life and productivity for people with type 1 or type 2 diabetes (16)(17)(18)(19). Consequently, the risk and experience of hypoglycemia have been connected to a range of emotional responses, including fear, anxiety, and concerns about safety (7,20,21).Frequency and severity of hypoglycemia have been found to be associated with psychological distress and a level