Impact of hypoglycemia on patients with type 2 diabetes mellitus and their quality of life, work productivity, and medication adherence
Open accessAbstract
BACKGROUND: The purpose of this study was to determine the characteristics of adults with type 2 diabetes mellitus (T2DM) that correlate with greater risk of hypoglycemia and determine the impact of hypoglycemia on health-related quality of life, work productivity, and medication adherence from a patient perspective. METHODS: Data from a large web-based survey were retrospectively analyzed. Adults with a diagnosis of T2DM taking antihyperglycemic agents were included in the analysis. Participants with knowledge of their hypoglycemic history were divided into three groups: those experiencing recent hypoglycemia (previous 3 months), those experiencing nonrecent hypoglycemia, and those never experiencing hypoglycemia. RESULTS: Of the participants with T2DM taking antihyperglycemic agents who were knowledgeable of their hypoglycemia history, 55.7% had ever experienced hypoglycemia. Of those, 52.7% had recent hypoglycemia. Compared with those who never experienced hypoglycemia, those who experienced hypoglycemia tended to: be younger; be more aware of their glycated hemoglobin (HbA1c) levels; have higher HbA1c levels; have a higher body mass index; have higher Charlson Comorbidity Index scores; be on insulin, sulfonylureas, and/or glucagon-like peptide-1 agonists; and be less adherent to their antihyperglycemic agents. Hypoglycemia interfered with social activities, caused more missed work (absenteeism), more impairment while at work (presenteeism), and decreased overall work productivity compared with patients who had never experienced hypoglycemia. Overall health-related quality of life, as determined by the Short Form-36 health questionnaire, was negatively impacted by hypoglycemia. Both Physical and Mental Summary scores were significantly lower for the recent hypoglycemia and nonrecent hypoglycemia groups compared with the never hypoglycemia group. CONCLUSION: Hypoglycemia can negatively impact many aspects of life. Greater awareness of those who are at risk for developing hypoglycemia can lead to the development of measures (eg, patient and physician education) to prevent future hypoglycemia episodes.
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Suboptimal A1C and adverse events like hypoglycemia should not be attributed solely to self-management behaviors without directly assessing those behaviors.
“Therefore, it is not appropriate to automatically attribute suboptimal A1C and adverse events such as hypoglycemia (17) solely to self-management behaviors without their direct assessment.”
From Psychosocial care for people with diabetes: a position statement of the American Diabetes Association (2016) · cites this paper as [17]
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 [73]
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- Authors
- Lopez, J., Annunziata, K., Bailey, R., Morisky, D. E., & Rupnow, M.
- Affiliations
- Janssen Scientific Affairs (United States) (US)
- Kantar Health (United States) (US)
- University of California, Los Angeles (US)
- Corresponding author
- Lopez, Janice
- ORCID
- Morisky, Donald E
- Venue
- Patient Preference and Adherence
- Publisher
- Informa UK Limited
- Published
- 2014-05
- Volume
- 8
- Pages
- 683
- ISSN
- 1177-889X (ISSN-L)
- PMC
- PMC4020884
- OpenAlex
- W1976179951
- Cited by
- 96
- References
- 25
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 11 · 2020: 11 · 2019: 10 · 2018: 11 · 2017: 10 · 2016: 13 · 2015: 10 · 2014: 1
- FWCI
- 9.11
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- 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)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- eScholarship (California Digital Library) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc)
- Funders
- Janssen Pharmaceuticals
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- hypoglycemia, type 2 diabetes, health-related quality of life, labor productivity, medication adherence, antidiabetic drugs, HbA1c, insulin, sulfonylureas, GLP-1 receptor agonists, absenteeism, presenteeism, hypoglycemia risk factors, patient education
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