Maria Chiara Rossi1, Antonio Nicolucci2, Alessandro Ozzello3, Sandro Gentile4, Alberto Aglialoro5, Anna Chiambretti6, Fabio Baccetti7, Francesco M Gentile8, Francesco Romeo9, Giuseppe Lucisano2, Carlo B Giorda9. 1. CORESEARCH - Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy. Electronic address: rossi@coresearch.it. 2. CORESEARCH - Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy. 3. Departmental Service of Diabetology and Metabolic Diseases, ASL TO3, Pinerolo, TO, Italy. 4. Campania University "Luigi Vanvitelli", Naples, Italy; Nefrocenter Research Network, Naples, Italy. 5. Metabolism and Diabetes Unit, Hospital St. Martin, Genoa, Italy. 6. Metabolism and Diabetes Unit, ASL TO4, Chivasso, TO, Italy. 7. Metabolism and Diabetes Unit, ASL 1, Massa, Carrara, Italy. 8. MEDIDIAB Metabolismo Endocrinologia Diabetologia, Bari, Italy. 9. Metabolism and Diabetes Unit, ASL TO5, Chieri, TO, Italy.
Abstract
BACKGROUND AND AIMS: Hypoglycemia represents a relevant burden in people with diabetes. Consequences of hypoglycemia/fear of hypoglycemia on quality of life (QoL) and behaviors of patients with T1DM and T2DM were assessed. METHODS AND RESULTS: HYPOS-1 was an observational retrospective study. Fear of hypoglycemia (Fear of Hypoglycemia Questionnaire, FHQ), general health status (visual analog scale of EuroQol questionnaire, EQ5D-VAS) psychological well-being (WHO-5 well being index, WHO-5), diabetes related distress (Problem Areas in Diabetes 5, PAID-5), and corrective/preventive behaviors following hypoglycemia were compared between people with and without previous experience of severe and symptomatic hypoglycemia and by tertiles of FHQ scores. A multivariate analysis was performed to identify factors associated with the likelihood of being in the third tertile of FHQ score. Overall, 2229 patients were involved. Severe hypoglycemia had statistically significant and clinically relevant (measured as effect sizes) negative impact on EQ5D-VAS, WHO-5, PAID-5, and FHQ both in T1DM and T2DM. In T2DM, symptomatic episodes had similar impact of severe hypoglycemia. Moving from the first to the third FHQ tertile, lower scores of EQ-5D VAS and WHO-5, and higher levels of PAID-5 were found. Patients in the third tertile performed more frequently corrective/preventive actions that negatively impact on metabolic control. Previous hypoglycemia, insulin treatment, female gender, age, and school education were the independent factors associated with increased likelihood to be in the third tertile. CONCLUSION: Not only severe but also symptomatic hypoglycemia negatively affect patient QoL, especially in T2DM. Addressing fear of hypoglycemia should be a goal of diabetes education.
BACKGROUND AND AIMS: Hypoglycemia represents a relevant burden in people with diabetes. Consequences of hypoglycemia/fear of hypoglycemia on quality of life (QoL) and behaviors of patients with T1DM and T2DM were assessed. METHODS AND RESULTS: HYPOS-1 was an observational retrospective study. Fear of hypoglycemia (Fear of Hypoglycemia Questionnaire, FHQ), general health status (visual analog scale of EuroQol questionnaire, EQ5D-VAS) psychological well-being (WHO-5 well being index, WHO-5), diabetes related distress (Problem Areas in Diabetes 5, PAID-5), and corrective/preventive behaviors following hypoglycemia were compared between people with and without previous experience of severe and symptomatic hypoglycemia and by tertiles of FHQ scores. A multivariate analysis was performed to identify factors associated with the likelihood of being in the third tertile of FHQ score. Overall, 2229 patients were involved. Severe hypoglycemia had statistically significant and clinically relevant (measured as effect sizes) negative impact on EQ5D-VAS, WHO-5, PAID-5, and FHQ both in T1DM and T2DM. In T2DM, symptomatic episodes had similar impact of severe hypoglycemia. Moving from the first to the third FHQ tertile, lower scores of EQ-5D VAS and WHO-5, and higher levels of PAID-5 were found. Patients in the third tertile performed more frequently corrective/preventive actions that negatively impact on metabolic control. Previous hypoglycemia, insulin treatment, female gender, age, and school education were the independent factors associated with increased likelihood to be in the third tertile. CONCLUSION: Not only severe but also symptomatic hypoglycemia negatively affect patient QoL, especially in T2DM. Addressing fear of hypoglycemia should be a goal of diabetes education.
Authors: Kevin A Matlock; Melanie Broadley; Christel Hendrieckx; Mark Clowes; Anthea Sutton; Simon R Heller; Bastiaan E de Galan; Frans Pouwer; Jane Speight Journal: Diabet Med Date: 2021-10-07 Impact factor: 4.213
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