Management of severe hypoglycaemia: cultural similarities, differences and resource consumption in three European countries

Abstract

Background: To investigate the characteristics of people with insulin-treated diabetes, who have experienced severe hypoglycaemic events (SHEs), in Germany, Spain or UK.

Methods: Patients with type 1 (n=319) or insulin-treated type 2 diabetes (n=320) who had experienced ≥1 SHE in the preceding year were enrolled. Their median age was 53 years (range, 16–94 years). Data were collected using a questionnaire administered by an experienced interviewer.

Results: The median number of reported SHEs was 2–3 in 12 months. Most events (69%) occurred at home, usually during the day or evening (74%) and most commonly due to insufficient food consumption (45%). In patients whose hypoglycaemia awareness was tested, 68% had normal awareness. Patients requiring emergency healthcare treatment frequently had impaired hypoglycaemia awareness, and developed hypoglycaemic coma more often. Hospital treatment was usually provided in an emergency department (72–94%). The duration of stay was longest in Germany. Following a SHE, patients receiving professional treatment were more likely to: consult their physician, test their blood glucose more often, adjust insulin dose and receive self-management training.

Conclusions: This survey of diabetes patients aged 16–94 years showed that SHEs represent a substantial burden on national healthcare systems in Germany, UK and Spain. The pattern of occurrence and treatment was similar in all three countries, despite differences in cultures and healthcare systems.

Key words::

• diabetes
• healthcare resource
• hypoglycaemia
• insulin-treated diabetes

Acknowledgements

Declaration of interests: Financial support for this study was provided by Novo Nordisk A/S (Denmark). The publication was supported by Novo Nordisk A/S (Denmark) with editorial assistance from ESP Bioscience (Sandhurst, UK).The authors are wholly responsible for the study design, analysis and scientific evaluation.

M.L. and M.H. are employees of and shareholders in Novo Nordisk. B.M.F. received a consultancy fee from Novo Nordisk for his advice during the design phase of the study, but received no financial reward for his subsequent participation as a co-investigator. He has served previously as a member of advisory boards for Novo Nordisk.