The psychosocial and financial impact of non-severe hypoglycemic events on people with diabetes: two international surveys

Abstract

Objectives:

To understand the impact of nocturnal and daytime non-severe hypoglycemic events on healthcare systems, work productivity and quality of life in people with type 1 or type 2 diabetes.

Methods:

People with diabetes who experienced a non-severe hypoglycemic event in the 4 weeks prior to the survey were eligible to participate in a nocturnal and/or daytime hypoglycemia survey. Surveys were conducted in Argentina, Australia, Brazil, Israel, Mexico and South Africa.

Results:

In total, 300 respondents were included in nocturnal/daytime hypoglycemia surveys (50/participating country/survey). All respondents with type 1 diabetes and 68%/62% (nocturnal/daytime) with type 2 diabetes were on insulin treatment. After an event, 25%/30% (nocturnal/daytime) of respondents decreased their insulin dose and 39%/36% (nocturnal/daytime) contacted a healthcare professional. In the week after an event, respondents performed an average of 5.6/6.4 (nocturnal/daytime) additional blood glucose tests. Almost half of the respondents (44%) reported that the event had a high impact on the quality of their sleep. Among nocturnal survey respondents working for pay, 29% went to work late, 16% left work early and 12% reported missing one or more full work days due to the surveyed event. In addition, 50%/39% (nocturnal/daytime) indicated that the event had a high impact on their fear of future hypoglycemia.

Conclusions:

The findings suggest that nocturnal and daytime non-severe hypoglycemic events have a large financial and psychosocial impact. Diabetes management that minimizes hypoglycemia while maintaining good glycemic control may positively impact upon the psychological wellbeing of people with diabetes, as well as reducing healthcare costs and increasing work productivity.

Keywords::

• Non-severe hypoglycemia
• Nocturnal
• Daytime
• Diabetes
• Survey
• Healthcare
• Economics
• Quality of life

Transparency

Declaration of funding

The surveys on which this manuscript are based were also funded by Novo Nordisk. The authors take full responsibility for the content of the manuscript, but are grateful to Watermeadow Medical for writing and editorial assistance, funded by Novo Nordisk.

Declaration of financial/other relationships

GF has received fees from Novo Nordisk for participating in an investigator-initiated study, advisory board participation and sponsorship to attend meetings. JS has been a consultant/advisor to Novo Nordisk, AstraZeneca, and Eli Lilly. JS has received a travel grant to present research from participated in research funded by Novo Nordisk. MB has been a consultant to Novo Nordisk. JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose. This manuscript has not been previously published and is not under consideration in the same or substantially similar form in any other peer-reviewed media. Partial data from the individual study countries have been presented as posters at ISPOR-EU 2013 and IDF 2013.