Non-severe nocturnal hypoglycemic events: experience and impacts on patient functioning and well-being

Abstract

PurposeNon-severe nocturnal hypoglycemic events (NSNHEs) are hypoglycemic events that occur during sleep but do not require medical assistance from another individual. This study was conducted to better understand the NSNHEs as patients actually experience them in their daily life, and how they impacted functioning and well-being.MethodsNine focus groups were held in four countries with diabetics (Type 1 and Type 2) who had experienced an NSNHE within the previous month: France (2 groups); Germany (2 groups); United Kingdom (2 groups); and United States (3 groups). These groups were audio-taped, translated to English where applicable, and analyzed thematically.ResultsSeventy-eight people with diabetes participated in the focus groups: 41 (53 %) were female and 37 (47 %) were male; 24 (31 %) had Type 1 diabetes, and 54 (69 %) had Type 2 diabetes. Participant reports were grouped into several major themes: next day effects, symptoms, sleep impacts, social impacts, corrective action, practical management, feelings about NSNHEs, and work impacts.ConclusionsPeople with both Type 1 and Type 2 diabetes experience NSNHEs. The range of impact on these patients is wide, from very mild to severe with a majority of participants experiencing strong impacts that limit their daily functioning. This finding suggests that NSNHEs are more impactful than previously believed.

A Patient-level Analysis of Efficacy and Hypoglycaemia Outcomes Across Treat-to-target Trials with Insulin Glargine Added to Oral Antidiabetes Agents in People with Type 2 Diabetes

“…21,22 Non-severe hypoglycaemia is also associated with a significant reduction in quality of life and accounts for a substantial reduction in work productivity. [23][24][25] The current pooled, post hoc analysis of patient-level data from n=906 and n=1,297; Fonseca study 31 n=792 and n=1,084, respectively). In addition, the previous study only reported symptomatic hypoglycaemia (including confirmed symptomatic and severe symptomatic), 31 whereas the current analysis provides additional information regarding rates of overall, daytime, nocturnal and severe hypoglycaemia.…”

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

“…To assess the impact of NSHE, a survey was developed based on the literature, expert input and interviews with 78 persons with either type 1 diabetes or type 2 diabetes who had recently experienced an NSHE, in nine focus groups across four countries (USA, UK, Germany and France)10. Survey items were developed based on a qualitative analysis of the expert input and the persons’ with diabetes interviews, and cognitively debriefed and pilot tested in English in nine persons who met the same eligibility criteria as the focus groups.…”

Driving and diabetes: are the changes in the European Union licensing regulations fit for purpose?

“…[26][27][28] Affected individuals felt tired, slow, depressed and restless on the day after nocturnal hypoglycaemia. [29][30][31] Negative effects have been reported on work attendance, performance and productivity.…”

“…[29][30][31] Negative effects have been reported on work attendance, performance and productivity. [28][29][30][31] There is evidence that hypoglycaemia during sleep is relevant to a person's ability to function normally after awakening, whether this is in the morning after nocturnal hypoglycaemia or at some other time of day. Following an episode of severe nocturnal hypoglycaemia, drivers should be advised to avoid driving the following day, at least in the hours after awakening.…”