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.
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.
Authors: David C Tabano; Melissa L Anderson; Debra P Ritzwoller; Arne Beck; Nikki Carroll; Paul A Fishman; David C Grossman Journal: J Occup Environ Med Date: 2018-11 Impact factor: 2.162
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Authors: David M Maahs; Bruce A Buckingham; Jessica R Castle; Ali Cinar; Edward R Damiano; Eyal Dassau; J Hans DeVries; Francis J Doyle; Steven C Griffen; Ahmad Haidar; Lutz Heinemann; Roman Hovorka; Timothy W Jones; Craig Kollman; Boris Kovatchev; Brian L Levy; Revital Nimri; David N O'Neal; Moshe Philip; Eric Renard; Steven J Russell; Stuart A Weinzimer; Howard Zisser; John W Lum Journal: Diabetes Care Date: 2016-07 Impact factor: 19.112