Impact of symptomatic hypoglycemia on medication adherence, patient satisfaction with treatment, and glycemic control in patients with type 2 diabetes

Walz, Lotta; Pettersson, Billie; Rosenqvist, Ulf; Deleskog, Anna; Journath, Gunilla; Wändell, Per

doi:10.2147/ppa.s58781

Cited by 75Medication Adherence and ComplianceDiabetes Treatment and ManagementDiabetes Management and Research

Impact of symptomatic hypoglycemia on medication adherence, patient satisfaction with treatment, and glycemic control in patients with type 2 diabetes

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Walz, Lotta, Pettersson, Billie, Rosenqvist, Ulf, Deleskog, Anna, Journath, Gunilla, Wändell, Per·2014·Patient Preference and Adherence

DOI 10.2147/ppa.s58781PMC PMC4011898

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Abstract

BACKGROUND: The purpose of this study was to evaluate the impact of symptomatic hypoglycemia on medication adherence, satisfaction with treatment, and glycemic control in patients with type 2 diabetes based on the treatment goals stated in the Swedish national guidelines. METHODS: This cross-sectional, multicenter study was carried out between January and August 2009 in 430 consecutive primary health care patients on stable doses of metformin and sulfonylureas for at least 6 months. The patients completed questionnaires covering their experiences of low blood glucose and adherence, as well as barriers to and satisfaction with drug treatment (using the Treatment Satisfaction Questionnaire for Medication). Physicians collected the data from medical records. RESULTS: Patients who experienced moderate or worse symptoms of hypoglycemia reported poorer adherence to medication (46% versus 67%; P<0.01) and were more likely to perceive barriers such as "bothered by medication side effects" (36% versus 14%; P<0.001) compared with patients with no or mild symptoms. Patients with moderate or worse symptoms of hypoglycemia were less satisfied with their treatment than those with no or mild symptoms as determined by the Treatment Satisfaction Questionnaire for Medication-Global satisfaction (67.0 versus 71.2; P<0.05). Overall, achievement of target glycated hemoglobin (HbA1c) based on the treatment goals stated in the Swedish national guidelines was 40%. Despite poorer adherence, patients who experienced moderate or worse symptoms of hypoglycemia had lower mean HbA1c values than patients with no or mild symptoms (7.0% versus 7.3% [Diabetes Control and Complications Trial standard]; P<0.05). CONCLUSION: Symptomatic hypoglycemia in patients with type 2 diabetes on metformin and sulfonylureas was associated with nonadherence and decreased treatment satisfaction despite lower mean HbA1c values. A broader understanding of patient preferences and self-reported outcomes could improve the management of patients with type 2 diabetes.

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Improvements in disease state have been shown to reduce diabetes distress and improve psychological well-being.
“Such improvements in disease state have been shown to reduce diabetes distress and improve psychological well-being (69,72,73).”
From Psychosocial care for people with diabetes: a position statement of the American Diabetes Association (2016) · cites this paper as [72]

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Self-citation
Effects of hypoglycemia on health-related quality of life, treatment satisfaction and healthcare resource utilization in patients with type 2 diabetes mellitus
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Authors: Walz, L., Pettersson, B., Rosenqvist, U., Deleskog, A., Journath, G., & Wändell, P.
Affiliations: Karolinska Institutet (SE)
Linköping University (SE)
Lasarettet i Motala (SE)
MSD (Sweden) (SE)
Corresponding author: Walz, Lotta
ORCID: Walz, Lotta
Deleskog, Anna
Journath, Gunilla
Wändell, Per
Venue: Patient Preference and Adherence
Publisher: Informa UK Limited
Published: 2014-04
Volume: 8
Pages: 593
ISSN: 1177-889X (ISSN-L)
DOI: 10.2147/ppa.s58781
PMC: PMC4011898
OpenAlex: W2077725161
Cited by: 75
References: 59
Citations by year: 2026: 3 · 2025: 3 · 2024: 3 · 2023: 6 · 2022: 4 · 2021: 1 · 2020: 7 · 2019: 11 · 2018: 10 · 2017: 11 · 2016: 8 · 2015: 6 · 2014: 2
FWCI: 9.29
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by-nc
creativecommons.org/licenses/by-nc/3.0/ (vor)
Locations: Patient Preference and Adherence (publishedVersion, cc-by-nc)
Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
DiVA (Linkoping University) (submittedVersion, other-oa)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
Topics: Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords: symptomatic hypoglycemia, type 2 diabetes, medication adherence, treatment satisfaction, glycemic control, HbA1c, metformin, sulfonylureas, patient preferences

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Impact of symptomatic hypoglycemia on medication adherence, patient satisfaction with treatment, and glycemic control in patients with type 2 diabetes

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