Medical resource use, disturbance of daily life and burden of hypoglycemia in insulin-treated patients with diabetes: results from a European online survey

Abstract

Hypoglycemia is common in patients with diabetes, and any severe hypoglycemic event can increase the fear of future hypoglycemic events. To try to reduce hypoglycemic events, many patients with diabetes maintain their blood glucose levels with a 'safety margin' (i.e., at higher than recommended values) and maintain hyperglycemia. Following this strategy leads to raised glycated hemoglobin levels, which are, consequently, linked to an increased risk of diabetic complications and increased healthcare costs. In the present survey (n = 1848), conducted in Germany, France and the UK, approximately a third of the patients were very worried about hypoglycemia, and a similar proportion reported maintaining hyperglycemia. Overall, the mean number of emergency room visits and hospitalizations (excluding emergency room visits) per patient per 12 months was 0.65 and 0.47, respectively. In addition, 10% of the patients reported that they had taken days off work because of hypoglycemia during the previous 12 months. Furthermore, 80% of diabetics in the three countries said they would value a meter that tells them when their blood glucose level is getting high/low at a particular time of the day. Thus, the survey outlines the potential scale, in a real-world setting, of 'hidden' costs associated with hypoglycemia and fear of hypoglycemia; such costs are likely to have a major detrimental impact on the overall emotional and economic burden of diabetes, which may be reduced through broader use of blood-glucose monitors for self-monitoring of blood glucose.

Association Between Hypoglycemia and Fall-Related Events in Type 2 Diabetes Mellitus: Analysis of a U.S. Commercial Database

“…A recent survey conducted in Germany, France, and the United Kingdom has shown the potential scale in a real-world setting of what the authors refer to as "hidden costs" associated with hypoglycemia, including absenteeism from work and disturbance of daily life due to fear of hypoglycemia. 33 for the Study of Diabetes position statement has also raised concerns about hypoglycemia and sulfonylurea use among the elderly, since they are at highest risk for hypoglycemia. 4,5 This position statement highlights the fact that sulfonylureas are associated with risk of hypoglycemia and recommend that medications predisposing patients to hypoglycemia should be avoided, since it may worsen myocardial ischemia and may cause dysrhythmias.…”

Glycemic Variability and Diabetes Complications: Does It Matter? Simply Put, There Are Better Glycemic Markers!

“…In addition, recent data reveal that annually there are now more emergency department visits and hospital admissions for hypoglycemia than there are for hyperglycemia (29). Hypoglycemia has long been known to cause seizures, coma, and death but is also strongly associated with CVD (30), all-site cancer (31), dementia (32), reduced quality of life, and excess resource utilization (33). While there is strong evidence supporting the link between HbA 1c and hypoglycemia with diabetes complications, the current evidence is much weaker for GV being a direct cause of diabetes complications (Table 2).…”

Cardiovascular Disease Risk Factors in Youth With Diabetes Mellitus

“…385,386 In the general adult population and in healthy children and adolescents, sleep alterations may adversely influence glucose regulation, 385 C-reactive protein, 387 and lipids 388 and increase the risk for hypertension, T2DM, heart attack, and stroke. 389,390 Reports of reduced sleep times of up to 64% 391 have been documented for children and adolescents with diabetes mellitus who confront additional challenges with sleep as a result of diabetes mellitus management 392,393 that may further disrupt sleep and add to adverse cardiovascular outcomes.…”