Self-Report of Hypoglycemia and Health-Related Quality of Life in Patients with Type 1 and Type 2 Diabetes |
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| Affiliation: | 1. Division of Endocrinology, Department of Internal Medicine, Rochester, Minnesota;2. Division of Health Care Policy & Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota;3. HealthPartners Institute for Education and Research, Bloomington, Minnesota;1. Internal Medicine Department, Carlos Haya Hospital, Malaga, Spain;2. CIBER Fisiopatologia de la Obesidad y la Nutricion (CB06/003), Malaga, Spain;3. Preventive Medicine Department, Malaga University, Malaga, Spain;4. Health Center “Ciudad Jardin,” Malaga, Spain;5. Research Laboratory, Internal Medicine Department, Carlos Haya Hospital, Malaga, Spain;6. Endocrinology and Nutrition Department, Virgen de la Victoria Hospital, Malaga, Spain;7. Biomedical Research Laboratory, Endocrinology and Nutrition Department, Virgen de la Victoria Hospital, Malaga, Spain;1. Division of Endocrinology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York;2. Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, New York;3. Division of Pediatric Otolaryngology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania;4. Department of Radiology, Jacobi Medical Center, Bronx, New York.;1. Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut;2. Department of Pediatrics, College of Medicine of Peoria, University of Illinois;1. Merck & Co., Inc., Kenilworth, NJ, USA;2. Kantar Health, New York, NY, USA |
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| Abstract: | ObjectiveTo establish the prevalence of self-reported hypoglycemia among ambulatory patients with diabetes and assess its impact on health-related quality of life (HRQoL).MethodsThis study was a cross-sectional analysis of a postal survey disbursed during the first quarter of 2010 to 875 adults with type 1 or 2 diabetes identified on the basis of an index clinical encounter for diabetes management between August 1, 2005 and June 30, 2006. The survey included questions regarding hypoglycemia, self-rating of health, and questions adapted from Confidence in Diabetes Self-Care, Generalized Anxiety Disorder-7, EuroQol5-D, and the Hypoglycemic Fear Survey. Data were analyzed using a two-sample t test for continuous variables and a chi-square test for categorical variables, with multivariate analysis to adjust for age, gender, diabetes duration, and Charlson comorbidity index.ResultsThe survey was completed by 418 patients (47.8% response rate). Of the respondents, 26 of 92 (28.3%) with type 1 and 55 of 326 (16.9%) with type 2 diabetes reported at least one episode of severe hypoglycemia within the previous 6 months. Fear of hypoglycemia, including engagement in anticipatory avoidance behaviors, was highest in patients with type 2 diabetes reporting severe hypoglycemia and all patients with type 1 diabetes (P<.001). HRQoL was lower in patients with type 2 (but not type 1) diabetes reporting severe hypoglycemia (P<.01).ConclusionClinicians and health systems should incorporate screening for hypoglycemia into the routine health assessment of all patients with diabetes. Fear of hypoglycemia places patients at risk for counterproductive behaviors, impairs HRQoL, and should be considered in individualizing glycemic goals. (Endocr Pract. 2013; 19:792-799) |
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