Understanding the economic, daily functioning, and diabetes management burden of non-severe nocturnal hypoglycemic events in Canada: differences between type 1 and type 2

Abstract

Objective:

To examine the daily functioning, diabetes management, and economic burden of non-severe nocturnal hypoglycemic events (NSNHEs) in Canada and differences in impacts by diabetes type.

Research design and methods:

A 20-min web-based survey, with items derived from the literature, expert and patient interviews, assessing the impact of NSNHEs, was administered to patients with self-reported diabetes aged ≥18 having an NSNHE in the past month.

Results:

Two thousand, two hundred and seventy-nine Canadian persons with diabetes were screened with 200 respondents meeting criteria and included in the analysis sample. Out of 87 working respondents, 15 reported on average 3.5 h of lost work (absenteeism). The reduction in work productivity (presenteeism) reported was comparable to the impact of arthritis. Other functional impacts included sleep and daily activities. Additionally, respondents’ increased their usual blood sugar monitoring practice, on average, 4.2 (SD = 7.5) extra tests were conducted in the week following the event and reduced their insulin over the following 4.8 days. Increased healthcare utilization was also reported. Increased costs as a result of NSNHE for lost work productivity, increased diabetes management, and resource utilization was CAD 70.67 per person per year in this sample. Limitations of the study include the biases which are associated with a web-based survey and self-reported data.

Conclusions:

NSNHEs have serious consequences for patients and diabetes management practices. Greater attention to treatments which reduce NSNHEs can have a major impact on improving functioning while reducing the economic burden of diabetes.

Keywords::

• Diabetes mellitus
• Nocturnal hypoglycemia
• Functional burden
• Cost of illness
• Disease management
• Diabetes type

Transparency

Declaration of funding

This study was funded by Novo Nordisk A/S.

Declaration of financial/other relationships

MB and DB are consultants/paid advisors to Novo Nordisk. MW and DG are employees of Novo Nordisk.

Previous presentation

Portions of this study were previously presented at the 15th Annual Canadian Diabetes Association conference in Vancouver, BC 2012.