Impact of hypoglycaemia on patient-reported outcomes from a global, 24-country study of 27,585 people with type 1 and insulin-treated type 2 diabetes
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AIMS: Data on the impact of hypoglycaemia on patients' daily lives and diabetes self-management, particularly in developing countries, are lacking. The aim of this study was to assess fear of, and responses to, hypoglycaemia experienced by patients globally. MATERIALS AND METHODS: This non-interventional, multicentre, 4-week prospective study using self-assessment questionnaires and patient diaries consisted of 27,585 patients, ≥18years, with type 1 diabetes (n=8022) or type 2 diabetes (n=19,563) treated with insulin for >12months, at 2004 sites in 24 countries worldwide. RESULTS: Increased blood glucose monitoring (69.7%) and seeking medical assistance (62.0%) were the most common responses in the 4weeks following hypoglycaemic events for patients with type 1 diabetes and type 2 diabetes, respectively. Approximately 44% of patients with type 1 diabetes or type 2 diabetes increased calorie intake in response to a hypoglycaemic episode. Following hypoglycaemia, 3.9% (type 1 diabetes) and 6.2% (type 2 diabetes) of patients took leave from work or study. Regional differences in fear of, and responses to, hypoglycaemia were evident - in particular, a lower level of hypoglycaemic fear and utilisation of healthcare resources in Northern Europe and Canada. CONCLUSIONS: Hypoglycaemia has a major impact on patients and their behaviour. These global data for the first time reveal regional variations in response to hypoglycaemia and highlight the importance of patient education and management strategies.
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Recurrent level 2 hypoglycemia and/or level 3 hypoglycemia is an urgent medical issue and requires intervention with medical treatment plan adjustment, behavioral intervention, and, in some cases, use of technology to assist with hypoglycemia prevention and identification.
“Recurrent level 2 hypoglycemia and/or level 3 hypoglycemia is an urgent medical issue and requires intervention with medical treatment plan adjustment, behavioral intervention, and, in some cases, use of technology to assist with hypoglycemia prevention and identification (76,(79)(80)(81)(82).”
From 6. Glycemic Targets: <i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [80]
Some individuals with type 1 diabetes or type 2 diabetes and hypoglycemia who have a fear of hyperglycemia are resistant to relaxation of glycemic targets.
“Conversely, some individuals with type 1 diabetes or type 2 diabetes and hypoglycemia who have a fear of hyperglycemia are resistant to relaxation of glycemic targets (74)(75)(76)(77)(78)(79)(80)(81)(82)(83).”
From 6. Glycemic Targets: <i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [80]
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Addala, A., Wong, J. J., Peñaranda, R. M., Hanes, S. J., Abujaradeh, H., Adams, R. N., Barley, R. C., Iturralde, E., Lanning, M. S., Tanenbaum, M. L., et al. (2023) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2023.108514 · Cited by 3 · see citing works
Hypoglycaemia among Insulin-Treated Patients with Diabetes: Southeast Asia Cohort of IO HAT Study
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Külcü, D. P., Altintas, M. G., & Çelebioğlu, A. (2025) · Journal of Nursology · doi:10.17049/jnursology.1555373 · Cited by 2 · see citing works
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Weight loss treatment for COVID-19 in patients with NCDs: a pilot prospective clinical trial
Oshakbayev, K., Durmanova, A., Zhankalova, Z. M., Idrisov, A., Bedelbayeva, G., Gazaliyeva, M., Nabiyev, A., Tordai, A., & Dukenbayeva, B. A. (2024) · Scientific Reports · doi:10.1038/s41598-024-61703-1 · Cited by 2 · see citing works
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Psychometric Properties and Dimensionality of the Greek Version of the Hypoglycemic Confidence Scale
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Factors That Affect Hypoglycemia Frequency and Severity in Diabetic Patients Using İnsulin
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Hypoglycemia Detection in Diabetes
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21. Yüzyıl’da Sağlık Bilimleri: Yöntem, Kuram ve Vaka
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- Authors
- Khunti, K., Alsifri, S., Aronson, R., Cigrovski Berković, M., Enters-Weijnen, C., Forsén, T., Galstyan, G., Geelhoed-Duijvestijn, P., Goldfracht, M., Gydesen, H., Kapur, R., Lalic, N., Ludvik, B., Moberg, E., Pedersen-Bjergaard, U., & Ramachandran, A.
- Affiliations
- University of Leicester (GB)
- Armed Forces Hospital (SA)
- LMC Diabetes & Endocrinology (Canada) (CA)
- University Medical Center Utrecht (NL)
- University of Helsinki (FI)
- Sechenov University (RU)
- Medisch Centrum Haaglanden (NL)
- Technion – Israel Institute of Technology (IL)
- Novo Nordisk (Denmark) (DK)
- University of Belgrade (RS)
- Krankenanstalt Rudolfstiftung der Stadt Wien (AT)
- Karolinska Institutet (SE)
- India Diabetes Research Foundation (IN)
- Corresponding author
- Khunti, Kamlesh
- Alsifri, Saud
- Aronson, Ronnie
- Enters-Weijnen, Catherine
- Forsén, Tom
- Galstyan, Gagik
- Geelhoed-Duijvestijn, Petronella
- Goldfracht, Margalit
- Gydesen, Helge
- Kapur, Rahul
- Lalic, Nebojsa
- Ludvik, Bernhard
- Moberg, Erik
- Ramachandran, Ambady
- ORCID
- Venue
- Diabetes Research and Clinical Practice
- Publisher
- Elsevier BV
- Published
- 2017-08
- Volume
- 130
- Pages
- 121-129
- ISSN
- 0168-8227 (ISSN-L)
- OpenAlex
- W2613962821
- Cited by
- 71
- References
- 32
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 9 · 2023: 7 · 2022: 9 · 2021: 14 · 2020: 11 · 2019: 5 · 2018: 10
- FWCI
- 5.61
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Research and Clinical Practice (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by-nc-nd)
- Figshare (submittedVersion, cc-by-nc-nd)
- Työväentutkimus Vuosikirja (submittedVersion)
- Leicester Research Archive (University of Leicester) (submittedVersion, cc-by-nc-nd)
- Funders
- Novo Nordisk A/S, Denmark
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care – East Midlands
- Leicester CIinical Trials Unit
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- hypoglycemia, type 1 diabetes, type 2 diabetes, insulin-treated diabetes, patient-reported outcomes, fear of hypoglycemia, blood glucose monitoring, health care utilization, absenteeism, regional variation, patient education
- MeSH terms
- Patient Reported Outcome Measures, Self-Management, Adult, Canada, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Europe, Fear, Female, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Male, Middle Aged, Patient Education as Topic, Prospective Studies, Surveys and Questionnaires
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