Impact of hypoglycaemia on patient-reported outcomes from a global, 24-country study of 27,585 people with type 1 and insulin-treated type 2 diabetes

Khunti, Kamlesh; Alsifri, Saud; Aronson, Ronnie; Berković, Maja Cigrovski; Enters-Weijnen, Catherine F; Forsén, Tom; Galstyan, Gagik Radikovich; Geelhoed-Duijvestijn, Petronella; Goldfracht, Margalit; Gydesen, Helge; Kapur, Rahul; Lalić, Nebojša; Ludvik, Bernhard; Moberg, Erik; Pedersen‐Bjergaard, Ulrik; Ramachandran, Ambady

doi:10.1016/j.diabres.2017.05.004

Cited by 59 publications

(59 citation statements)

References 34 publications

(45 reference statements)

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“…Even among patients with T2D who initiate basal insulin, it is estimated that only 30% achieve their individual glycemic target, in part due to concerns around hypoglycaemia which may result in less timely and effective insulin titration . It has also been shown that hypoglycaemia leads to poor adherence and clinical outcomes, concurrent with increased healthcare resource use . Our treatment discontinuation data for both cohorts are therefore in line with observed rates from other studies.…”

Section: Discussionsupporting

confidence: 86%

“…20,21 It has also been shown that hypoglycaemia leads to poor adherence and clinical outcomes, concurrent with increased healthcare resource use. [22][23][24] Our treatment discontinuation data for both cohorts are therefore in line with observed rates from other studies. Differences in baseline demographics and clinical characteristics may guide physicians' prescribing decisions.…”

Section: Change In A1csupporting

confidence: 90%

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Hypoglycaemia and treatment patterns among insulin‐treated patients with type 2 diabetes who switched to insulin glargine 300 units/mL versus other basal insulin in a real‐world setting

Zhou

Nicholls

Xie

et al. 2019

Endocrino Diabet & Metabol

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Introduction Type 2 diabetes (T2D) is characterized by worsening pancreatic β‐cell function often requiring treatment escalation with oral antidiabetic drugs ( OAD s), glucagon‐like peptide‐1 and eventually insulin. Although there is much evidence available on the initiation of basal insulins, fewer studies have investigated the effects of switching from one basal insulin to another. This study aims to evaluate treatment persistence and hypoglycaemia in adult patients with T2D on prior basal insulin who were switched to insulin glargine 300 units/mL (Gla‐300) or other basal insulins in a real‐world setting. Materials and methods This study is a retrospective cohort analysis of patient‐level data extracted from the Optum ® Clinformatics ™ database between 1 October 2014 and 30 June 2016. Adult patients (≥18 years) with T2D who were being treated with basal insulin during the 6‐month baseline period, who switched to either Gla‐300 or other basal insulins, were followed up for ≥3 months after switching. Outcomes included treatment persistence, and incidence and number of hypoglycaemic events. Results Of the included patients, 1204 switched to Gla‐300 and 616 switched to other basal insulins. Adjusting for baseline confounders, patients who switched to Gla‐300 were 34% less likely to discontinue their basal insulin than patients who switched to other basal insulins (hazard ratio [ HR ] 0.66; 95% confidence interval [ CI ] 0.54‐0.81; P < 0.001). Patients who switched to Gla‐300 were less likely to experience hypoglycaemia at 3‐month follow‐up (odds ratio [ OR ] 0.56, 95% CI 0.32‐0.97; P = 0.039) and at 6‐month follow‐up ( OR 0.58, 95% CI 0.38‐0.87; P = 0.009) compared with patients who switched to other basal insulins. Conclusions Patients with T2D on prior basal insulin in a real‐world setting who switched to Gla‐300 were more persistent with their basal insulin and experienced less hypoglycaemia than patients who switched to other basal insulins.

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Section: Discussionsupporting

confidence: 86%

Section: Change In A1csupporting

confidence: 90%

Hypoglycaemia and treatment patterns among insulin‐treated patients with type 2 diabetes who switched to insulin glargine 300 units/mL versus other basal insulin in a real‐world setting

Zhou

Nicholls

Xie

et al. 2019

Endocrino Diabet & Metabol

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“…Furthermore, hypoglycaemia has a well‐established significant negative impact on well‐being, productivity and quality of life (QOL) . Recent studies have confirmed that, in addition to decreased overall health‐related QOL, hypoglycaemia can negatively impact physical and mental well‐being, limit mobility, lead to anxiety and depression, interfere with social activities, result in missed work (absenteeism), impair performance while at work (presenteeism) and decrease overall work productivity . In addition to an economic burden for patients, hypoglycaemia is associated with increased healthcare resource utilization and health‐economic burden .…”

Section: Introductionmentioning

confidence: 99%

“…In addition to an economic burden for patients, hypoglycaemia is associated with increased healthcare resource utilization and health‐economic burden . Severe hypoglycaemia events frequently result in emergency/ambulance calls and hospital treatment and, hence, incur substantial healthcare costs …”

Section: Introductionmentioning

confidence: 99%

“…6 Recent studies have confirmed that, in addition to decreased overall health-related QOL, hypoglycaemia can negatively impact physical and mental well-being, limit mobility, lead to anxiety and depression, interfere with social activities, result in missed work (absenteeism), impair performance while at work (presenteeism) and decrease overall work productivity. [7][8][9][10][11][12] In addition to an economic burden for patients, hypoglycaemia is associated with increased healthcare resource utilization and health-economic burden. [7][8][9] Severe hypoglycaemia events frequently result in emergency/ambulance calls and hospital treatment and, hence, incur substantial healthcare costs.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the HAT study, the largest global hypoglycaemia study to date, with similar large real‐world studies

Pedersen‐Bjergaard

Alsifri

Aronson

et al. 2018

Diabetes Obesity Metabolism

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Aims Optimal diabetes care requires clear understanding of the incidence of hypoglycaemia in real‐world clinical practice. Current data on hypoglycaemia are generally limited to those reported from randomised controlled clinical trials. The Hypoglycaemia Assessment Tool (HAT) study, a non‐interventional real‐world study of hypoglycaemia, assessed hypoglycaemia in 27 585 individuals across 24 countries. The present study compared the incidence of hypoglycaemia from the HAT study with other similarly designed, large, real‐world studies. Materials and Methods A literature search of PubMed (1995‐2017) for population‐based studies of insulin‐treated patients with type 1 or type 2 diabetes (T1D, T2D), excluding clinical trials and reviews, identified comparable population‐based studies reporting the incidence of hypoglycaemia. Results The 24 comparative studies, including more than 24 000 participants with T1D and more than 160 000 participants with T2D, varied in design, size, inclusion criteria, definitions of hypoglycaemia and method of recording hypoglycaemia. Reported rates (events per patient‐year [PPY]) of hypoglycaemia were higher in patients with T1D than in those with T2D (overall T1D, 21.8‐73.3 and T2D, 1.3‐37.7; mild/non‐severe T1D, 29.0‐126.7 and T2D, 1.3‐41.5; severe T1D, 0.7‐5.8 and T2D, 0.0‐2.5; nocturnal T1D, 2.6‐11.3 and T2D, 0.38‐9.7) and were similar to the ranges found in the HAT study. Conclusions The HAT data on hypoglycaemia incidence were comparable with those from other real‐world studies and indicate a high incidence of hypoglycaemia among insulin‐treated patients. Differences in rates among studies are mostly explained by differences in patient populations and study methodology. The goal of reducing hypoglycaemia should be a target for continued educational and evidence‐based pharmacological interventions.

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Diabetes in Childhood

Ikle,

Addala,

Maahs

2024

Textbook of Diabetes

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Impact of hypoglycaemia on patient-reported outcomes from a global, 24-country study of 27,585 people with type 1 and insulin-treated type 2 diabetes

Abstract: Hypoglycaemia has a major impact on patients and their behaviour. These global data for the first time reveal regional variations in response to hypoglycaemia and highlight the importance of patient education and management strategies.

Cited by 59 publications

References 34 publications

Hypoglycaemia and treatment patterns among insulin‐treated patients with type 2 diabetes who switched to insulin glargine 300 units/mL versus other basal insulin in a real‐world setting

Hypoglycaemia and treatment patterns among insulin‐treated patients with type 2 diabetes who switched to insulin glargine 300 units/mL versus other basal insulin in a real‐world setting

Comparison of the HAT study, the largest global hypoglycaemia study to date, with similar large real‐world studies

Diabetes in Childhood

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