The economic and quality of life impact of hypoglycemia

Abstract

Hypoglycemia is an often underrecognized side effect of type 2 diabetes therapy. This study assessed the burden of hypoglycemia in this population in Sweden and included 309 patients aged 35 years or older and treated with insulin and/or oral antidiabetic agents. Data were gathered through patient questionnaires/interviews and chart reviews. The results showed that 115 patients (37%) reported symptoms of hypoglycemia during the preceding month. Patients with hypoglycemia were more affected by their diabetes, reported lower general health, and were more anxious about hypoglycemia than those without hypoglycemia. The direct and indirect costs of hypoglycemia per patient with hypoglycemic symptoms were estimated to be U.S. $12.9 and $14.1, respectively, for a 1-month period. The results indicate that hypoglycemia is common, and that a reduction in these symptoms, without reducing glycemic control, may improve patient well-being and possibly also reduce cost.

Cost-effectiveness of insulin detemir compared with NPH insulin in people with type 2 diabetes in Denmark, Finland, Norway, and Sweden

“…Similar or higher rates of non-severe hypoglycaemia have been observed in other observational studies [49][50][51] . The applied baseline rate of hypoglycaemic events reflects people that have been on insulin therapy for less than two years.…”

“…This assumption is supported when comparing with data from other observational studies in people with T2DM where hypoglycaemia incidence rates were higher [49][50][51] .…”

“…In comparison, a utility decrement of 0.0052 per hypoglycaemic event avoided was applied in a health technology assessment performed for NICE 42 , and in a study from Sweden a disutility of 0.07 was reported in a group of T2DM patients experiencing symptoms of hypoglycaemia during the last month in comparison to a patient group not experiencing these symptoms 51 . Hence, the utility decrement estimate used in these analyses was lower than utility decrement estimates used elsewhere and may also be considered a conservative estimate.…”

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“…In addition, almost all participants taking drugs that could cause hypoglycemia had been informed about the possibility of blood glucose testing. In the study by Lundqvist [8], hypoglycemia was verified with a blood glucose test. This raised the question as to whether the participants in the present study, and in the study by Pettersson et al [17], were really convinced that they had had hypoglycemia.…”

“…Achieving the balance between high or low blood glucose is challenging [4,8]. Studies on low blood glucose in people with type 2 diabetes are difficult to compare due to the rate of hypoglycemia and different definitions, data collection methods, drug type/regimens, and patient populations [9,10].…”