Inertia on hypoglycemia: Highlight from a Taiwan subgroup analysis of Real-Life Effectiveness and Care Patterns of Diabetes Management (RECAP-DM) study

Wang, Chih‐Yuan; Lin, Ching-Ling; Huang, Tien-Shiang; Chien, Ming-Nan; Hsieh, Sheng-Hwu; Huang, Yu‐Yao; Shih, KC; Tu, Shih‐Te; Chang, Chwen‐Tzuei; Huang, Chien‐Ning; Chou, Chien-Wen; Wu, Ta Jen; Liu, Rue‐Tsuan; Lam, Hing‐Chung; Kwok, Ching Fai; Fu, Chen-Chung; Sheu, Wayne Huey‐Herng

doi:10.1016/j.diabres.2012.05.017

Cited by 10 publications

(6 citation statements)

References 31 publications

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“…However, female participants exhibited significantly higher FBS and HbA1c levels than male participants. This finding is consistent with the results of the Real-Life Effectiveness and Care Patterns of Diabetes Management study, which evaluated a randomly selected sample of patients with T2DM from across Taiwan (33) . The finding that only a few participants were newly diagnosed with CVD during the follow-up may also have contributed to the null effect.…”

Section: Discussionsupporting

confidence: 88%

Alternative health eating index and the Dietary Guidelines from American Diabetes Association both may reduce the risk of cardiovascular disease in type 2 diabetes patients

Huang

Lei

et al. 2015

J Human Nutrition Diet

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Section: Discussionsupporting

confidence: 88%

Alternative health eating index and the Dietary Guidelines from American Diabetes Association both may reduce the risk of cardiovascular disease in type 2 diabetes patients

Huang

Lei

et al. 2015

J Human Nutrition Diet

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“…In seven studies [9,12,13,22,26,27,30], univariate analyses showed that greater severity of hypoglycaemia was associated with lower health status and this was confirmed by multivariate analyses in four studies [9,12,26,30]. Two studies [31,36] did not observe a difference comparing severity levels. In a 1-year prospective study [21], no significant differences in health status (EQ-5D) were observed between three (selftreated) levels of hypoglycaemia at baseline and follow-up.…”

Section: Severe Hypoglycaemia and Generic Health Statusmentioning

confidence: 82%

“…Although six studies were prospective , for most of these, only cross‐sectional (baseline) data were relevant to the aims of the current review. In 16 studies the aim was to examine the association between hypoglycaemia and PROs. One study established a minimum important difference and another determined a clinically meaningful cut‐off score for fear of hypoglycaemia .…”

Section: Resultsmentioning

confidence: 99%

Impact of severe hypoglycaemia on psychological outcomes in adults with Type 2 diabetes: a systematic review

et al. 2019

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Aim Hypoglycaemia affects many people with Type 2 diabetes using insulin and other glucose‐lowering therapies. This systematic review examined the impact of severe hypoglycaemia (episodes requiring external assistance) on psychological outcomes (e.g. emotional well‐being, health status and quality of life) in adults with Type 2 diabetes. Methods MEDLINE Complete, PsycINFO and CINAHL databases were searched for peer‐reviewed empirical studies, published in English, reporting the occurrence and severity of hypoglycaemia and its relationship with patient‐reported outcomes (PROs) in adults with Type 2 diabetes. Data were extracted from published reports and analysed. Results Of 3756 potentially relevant abstracts, 29 studies met the inclusion criteria. Most reported cross‐sectional data and sample sizes varied widely (N = 71 to 17 563). Although definitions of mild and severe hypoglycaemia were largely consistent between studies, additional non‐standard categorizations (e.g. moderate, very severe) were apparent and recall periods varied. Overall, severe hypoglycaemia was associated with increased fear of hypoglycaemia and decreased emotional well‐being, health status and diabetes‐specific quality of life. Effect sizes show that the association with fear of hypoglycaemia was stronger than with general health status. Conclusions Notwithstanding the limitations of the empirical studies, these findings indicate that severe hypoglycaemia in adults with Type 2 diabetes (insulin‐ and non‐insulin‐treated) is associated with impaired psychological outcomes. Healthcare professionals should address the psychological impact of severe hypoglycaemia during clinical consultations, to support individuals to minimize exposure to, and the psychological consequences of, severe hypoglycaemia.

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“…A lower proportion of patients with hypoglycemia has been reported in Asian Pacific countries and Taiwan (20), which may be explained by more conservative treatment strategies in Taiwanese clinical diabetes control (21). …”

Section: Discussionmentioning

confidence: 99%

Association of Clinical Symptomatic Hypoglycemia With Cardiovascular Events and Total Mortality in Type 2 Diabetes

et al. 2013

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OBJECTIVEHypoglycemia is associated with serious health outcomes for patients treated for diabetes. However, the outcome of outpatients with type 2 diabetes who have experienced hypoglycemia episodes is largely unknown.RESEARCH DESIGN AND METHODSThe study population, derived from the National Health Insurance Research Database released by the Taiwan National Health Research Institutes during 1998–2009, comprised 77,611 patients with newly diagnosed type 2 diabetes. We designed a prospective study consisting of randomly selected hypoglycemic type 2 diabetic patients and matched type 2 diabetic patients without hypoglycemia. We investigated the relationships of hypoglycemia with total mortality and cardiovascular events, including stroke, coronary heart disease, cardiovascular diseases, and all-cause hospitalization.RESULTSThere were 1,844 hypoglycemic events (500 inpatients and 1,344 outpatients) among the 77,611 patients. Both mild (outpatient) and severe (inpatient) hypoglycemia cases had a higher percentage of comorbidities, including hypertension, renal diseases, cancer, stroke, and heart disease. In multivariate Cox regression models, including diabetes treatment adjustment, diabetic patients with hypoglycemia had a significantly higher risk of cardiovascular events during clinical treatment periods. After constructing a model adjusted with propensity scores, mild and severe hypoglycemia still demonstrated higher hazard ratios (HRs) for cardiovascular diseases (HR 2.09 [95% CI 1.63–2.67]), all-cause hospitalization (2.51 [2.00–3.16]), and total mortality (2.48 [1.41–4.38]).CONCLUSIONSSymptomatic hypoglycemia, whether clinically mild or severe, is associated with an increased risk of cardiovascular events, all-cause hospitalization, and all-cause mortality. More attention may be needed for diabetic patients with hypoglycemic episodes.

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Inertia on hypoglycemia: Highlight from a Taiwan subgroup analysis of Real-Life Effectiveness and Care Patterns of Diabetes Management (RECAP-DM) study

Cited by 10 publications

References 31 publications

Alternative health eating index and the Dietary Guidelines from American Diabetes Association both may reduce the risk of cardiovascular disease in type 2 diabetes patients

Alternative health eating index and the Dietary Guidelines from American Diabetes Association both may reduce the risk of cardiovascular disease in type 2 diabetes patients

Impact of severe hypoglycaemia on psychological outcomes in adults with Type 2 diabetes: a systematic review

Association of Clinical Symptomatic Hypoglycemia With Cardiovascular Events and Total Mortality in Type 2 Diabetes

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