A nine country study of the burden of non‐severe nocturnal hypoglycaemic events on diabetes management and daily function

Brod, Meryl; Wolden, Michael Lyng; Christensen, Torsten; Bushnell, Donald M.

doi:10.1111/dom.12070

Cited by 67 publications

(91 citation statements)

References 19 publications

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“…This observation is in agreement with previously published international surveys, suggesting that the burden of NSHEs is an artefact of hypoglycemia and not culturally determined11. In particular, NSHEs have a detrimental effect on patients’ quality of life, hindering their ability to carry out usual activities.…”

Section: Discussionsupporting

confidence: 92%

“…In contrast to surveys carried out in other countries, NSHEs have a comparatively lower impact on work productivity and absenteeism in Japan11. We speculate that cultural differences in the acceptability of absenteeism might contribute to this observation.…”

Section: Discussioncontrasting

confidence: 80%

“…In total, 19% of respondents in the present study modified their insulin dose during the 7 days after an NSHE – a value slightly higher than has been reported in other countries using a similar survey (15.8%)11. Altering, and in particular decreasing, insulin dose might have negative consequences for glycemic control.…”

Section: Discussioncontrasting

confidence: 65%

“…However, respondents in this Japanese survey undertook slightly fewer additional self‐measured blood glucose tests (2.95) in the 7 days after a night‐time NSHE compared with respondents in other countries (3.6)11.…”

Section: Discussionmentioning

confidence: 86%

“…We speculate that cultural differences in the acceptability of absenteeism might contribute to this observation. Conversely, 29.7% of Japanese patients visited a healthcare professional after a hypoglycemic episode compared with ~15% in other countries11. The decision to visit a healthcare professional instead of choosing self‐management after an NSHE could also be due to cultural factors; however, the increased number of interactions with healthcare professionals in Japan is likely to have significant cost implications that could exceed the potential savings made through reduced workplace absenteeism.…”

Section: Discussionmentioning

confidence: 99%

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Diabetes management and daily functioning burden of non‐severe hypoglycemia in Japanese people treated with insulin

Ohashi

Wolden

Hyllested‐Winge³

et al. 2017

J of Diabetes Invest

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Aims/IntroductionThe present study investigated the impact of non‐severe hypoglycemic events (NSHE) on patients’ diabetes management, daily functioning and well‐being.Materials and MethodsA survey assessing the impact of NSHEs was completed by insulin‐treated Japanese people with diabetes, aged ≥20 years with self‐reported diabetes, who had experienced at least one NSHE in the past 3 months. Survey questions captured reasons for and the length of the event, and impacts on diabetes management, daily functioning, sleep and well‐being.ResultsA total of 3,145 people with type 1 diabetes mellitus and type 2 diabetes mellitus were screened, of which 411 respondents were eligible. Increased glucose monitoring was reported by 57 and 54% of respondents after daytime and night‐time NSHE, respectively. The average number of additional glucose monitoring tests was 2.4 and 3.0 for daytime and night‐time NSHE. Among all respondents, 19% (daytime) and 16% (night‐time) changed their insulin dose after an NSHE. After a daytime NSHE, 25% of respondents reported a negative impact on their daily activities or work. After a night‐time NSHE, 34 and 23% of respondents reported a negative impact on sleep and next day emotional state, respectively.Conclusions NSHEs have a negative impact on the diabetes management, daily functioning, sleep and well‐being of Japanese patients.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 80%

Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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Diabetes management and daily functioning burden of non‐severe hypoglycemia in Japanese people treated with insulin

Ohashi

Wolden

Hyllested‐Winge³

et al. 2017

J of Diabetes Invest

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Effect of Continuous Glucose Monitoring on Glycemic Control in Adults With Type 1 Diabetes Using Insulin Injections

Beck

Riddlesworth

Ruedy

et al. 2017

JAMA

927

741

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IMPORTANCEPrevious clinical trials showing the benefit of continuous glucose monitoring (CGM) in the management of type 1 diabetes predominantly have included adults using insulin pumps, even though the majority of adults with type 1 diabetes administer insulin by injection.OBJECTIVE To determine the effectiveness of CGM in adults with type 1 diabetes treated with insulin injections.DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial conducted between October 2014 and May 2016 at 24 endocrinology practices in the United States that included 158 adults with type 1 diabetes who were using multiple daily insulin injections and had hemoglobin A 1c (HbA 1c ) levels of 7.5% to 9.9%.INTERVENTIONS Random assignment 2:1 to CGM (n = 105) or usual care (control group; n = 53).MAIN OUTCOMES AND MEASURES Primary outcome measure was the difference in change in central-laboratory-measured HbA 1c level from baseline to 24 weeks. There were 18 secondary or exploratory end points, of which 15 are reported in this article, including duration of hypoglycemia at less than 70 mg/dL, measured with CGM for 7 days at 12 and 24 weeks. RESULTS Among the 158 randomized participants (mean age, 48 years [SD, 13]; 44% women; mean baseline HbA 1c level, 8.6% [SD, 0.6%]; and median diabetes duration, 19 years [interquartile range, 10-31 years]), 155 (98%) completed the study. In the CGM group, 93% used CGM 6 d/wk or more in month 6. Mean HbA 1c reduction from baseline was 1.1% at 12 weeks and 1.0% at 24 weeks in the CGM group and 0.5% and 0.4%, respectively, in the control group (repeated-measures model P < .001). At 24 weeks, the adjusted treatment-group difference in mean change in HbA 1c level from baseline was -0.6% (95% CI, -0.8% to -0.3%; P < .001). Median duration of hypoglycemia at less than <70 mg/dL was 43 min/d (IQR, 27-69) in the CGM group vs 80 min/d (IQR, in the control group (P = .002). Severe hypoglycemia events occurred in 2 participants in each group.CONCLUSIONS AND RELEVANCE Among adults with type 1 diabetes who used multiple daily insulin injections, the use of CGM compared with usual care resulted in a greater decrease in HbA 1c level during 24 weeks. Further research is needed to assess longer-term effectiveness, as well as clinical outcomes and adverse effects.

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Severity of hypoglycaemia and health‐related quality of life, work productivity and healthcare costs in patients with type 2 diabetes in Europe

Pawaskar

Witt

Engel

et al. 2018

Endocrino Diabet & Metabol

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SummaryAims: Hypoglycaemia in patients with type 2 diabetes mellitus (T2DM) is associated with poor health outcomes, such as reduced health-related quality of life (HRQoL).This study aimed to assess the impact of hypoglycaemic events by severity on HRQoL, work productivity and healthcare costs in patients with T2DM. Materials and Methods: European patients with T2DM selected from the NationalHealth and Wellness Survey who were currently receiving pharmacologic therapy were stratified into 3 groups based on the reported history and severity of hypoglycaemic events (no event, nonsevere, severe) experienced in the previous 3 months.Patients' work productivity, HRQoL, healthcare resource use (HCRU) and associated costs were assessed as self-reported outcomes. Results:Of 1269 patients included in the study, 652 (51.4%) patients had not experienced an event, while 533 (42.0%) and 84 (6.6%) patients had experienced nonsevere and severe hypoglycaemic events, respectively, in the previous 3 months. An increase in hypoglycaemia severity was associated with a decrease in HRQoL, and an increase in HCRU and healthcare costs. Conclusions:The impact of hypoglycaemia varies by severity and has a negative impact on HRQoL and overall HCRU and costs. K E Y W O R D Seconomic burden, healthcare resource use, health-related quality of life, hypoglycaemia, type 2 diabetes mellitus, work productivity

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A nine country study of the burden of non‐severe nocturnal hypoglycaemic events on diabetes management and daily function

Cited by 67 publications

References 19 publications

Diabetes management and daily functioning burden of non‐severe hypoglycemia in Japanese people treated with insulin

Diabetes management and daily functioning burden of non‐severe hypoglycemia in Japanese people treated with insulin

Effect of Continuous Glucose Monitoring on Glycemic Control in Adults With Type 1 Diabetes Using Insulin Injections

Severity of hypoglycaemia and health‐related quality of life, work productivity and healthcare costs in patients with type 2 diabetes in Europe

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