The impact of non-severe hypoglycemic events on daytime function and diabetes management among adults with type 1 and type 2 diabetes

Abstract

Objectives:

To describe daytime non-severe hypoglycemic events (NSHEs), assess their impact on patient functioning and diabetes self-management, and examine if these impacts differ by diabetes type or country.

Methods:

Internet survey to adults with diabetes in the US, UK, Germany, and France.

Results:

Of 6756 screened respondents, 2439 reported a daytime NSHE in the past month. NSHEs occurred while active (e.g., running errands) (45.1%), 29.6% while not active (e.g., watching TV), and 23.8% at work. On average, it took half a day to respond and recover from NSHE. Respondents monitored their glucose 5.7 extra times on average over the following week. On the day of event, type 1 respondents tested significantly more often than type 2 (p < 0.05). Type 2 were less likely to confirm NSHE with glucose test (p < 0.001). Following NSHE, 12.6% of respondents reduced total insulin by an average of 7.6 units (SD = 8.3). Total units and days with reduced dosing was significantly less, whilst number of additional glucose tests and time to recover was significantly longer if NSHE occurred at work (p < 0.001). Type 1 decreased insulin doses more often (p < 0.001); however, type 2 decreased a greater number of units (p < 0.01). Compared with other countries, US respondents were more likely to eat a light or full meal and respondents in France took significantly longer than all other countries to recognize (p < 0.05), respond to (p < 0.001), and recover from (p < 0.001) NSHE, used significantly more monitoring tests the day of (p < 0.05) and over the subsequent week (p < 0.001), and decreased their normal insulin dose more (p < 0.001). Limitations of the study include potential recall bias and selection bias.

Conclusions:

NSHEs are associated with a significant impact on patient functioning and diabetes management.

Keywords::

• Hypoglycemia
• Quality-of-life
• Productivity
• Disease management
• Diabetes mellitus

Transparency

Declaration of funding

This study was funded by Novo Nordisk A/S. Mr Christensen contributed to the survey design and preparation of the manuscript.

Declaration of financial or other relationships

Dr Brod and Mr Bushnell are advisors/paid consultants to Novo Nordisk A/S. Mr Christensen is an employee of Novo Nordisk A/S.

Acknowledgments

No assistance in the preparation of this article is to be declared.