Patient-reported frequency, awareness and patient-physician communication of hypoglycaemia in Belgium

Peene, Bernard; d'Hooge, D; Vandebrouck, T.; Mathieu, Chantal

doi:10.1179/2295333714y.0000000050

Cited by 18 publications

(18 citation statements)

References 23 publications

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“…A minority of patients in our study reported awareness of hypoglycemia (5.9%); the majority however reported either impaired awareness (83.4%) or unawareness (10.7%). Similar findings were found in previous studies in different countries ranging from 43% to 75% (Gehlaut et al, 2015; Kulzer, Seitz & Kern, 2014; Peene et al, 2014; Östenson et al, 2014). In our study, people who reported impaired awareness of hypoglycemia were higher.…”

Section: Discussionsupporting

confidence: 92%

Self-reported frequency, severity of, and awareness of hypoglycemia in type 2 diabetes patients in Turkey

Besen

Sürücü

Koşar

2016

PeerJ

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ObjectivesHypoglycemia is a common side effect of insulin therapy in type 1 and type 2 diabetes. Limited data exist on the frequency of hypoglycemic events in type 2 diabetic patients in Turkey. Our study investigated self-reported hypoglycemic events and awareness of hypoglycemia in Turkish patients with type 2 diabetes.MethodsPeople with type 2 diabetes older than 18 years of age were recruited from the two university hospital diabetes clinics. The frequency and severity of hypoglycemia and awareness of hypoglycemia during the preceding year were determinated using questionnaires by the face-to-face interview method.ResultsIn this study of 187 patients with type 2 diabetes, 83.4% had impaired awareness of their hypoglycemia, and 62% reported that they had missed some of the symptoms of hypoglycemia. Of the patients reporting hypoglycemic symptoms and severity level, 84.1% experienced mild hypoglycemia, 60% moderate, and 15.5% severe hypoglycemia in the past year. No significant association was made between hypoglycemia awareness and age, body-mass index (BMI), years of diabetes, dose of insulin, duration of insulin use, number of meals, or amount of snacking. A significant correlation was found between A1c levels and hypoglycemia awareness and severity of hypoglycemia. A significant correlation was found between dose of insulin, amount of snacking, and severity of hypoglycemia. No significant association was made between severity of hypoglycemia and age, BMI, years of diabetes, duration of insulin use, or the number of meals. However, the group with severe hypoglycemia had diabetes longer, and the average daily dose of insulin use was higher than in other groups.ConclusionsAccording to the study results, the percentage of patients with impaired awareness of hypoglycemia is high, and 62% of patients reported that they had missed some of the symptoms of hypoglycemia in type 2 diabetes. In addition, the percentage of severe hypoglycemic events is not low. Impaired awareness of hypoglycemia is a major risk factor for severe hypoglycemic events. Patients should be educated about the danger of hypoglycemia. Education should be improved, and a determined attempt should be made to eradicate the problem.

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Section: Discussionsupporting

confidence: 92%

Self-reported frequency, severity of, and awareness of hypoglycemia in type 2 diabetes patients in Turkey

Besen

Sürücü

Koşar

2016

PeerJ

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“…This compares with an overall crude rate of 1.4 ± 2.1 events ( n =37) in the present study over the same period, despite a greater proportion of insulin and sulfonylurea users at baseline (56%), with only two participants not on hypoglycaemic medication. This rate is substantially lower compared with recently published rates of hypoglycaemia in comparable populations . This is probably explained by the combination of hypoglycaemic education, a proactive reduction in hypoglycaemic medication, and weekly contact to discuss hypoglycaemia.…”

Section: Discussioncontrasting

confidence: 63%

“…Our primary outcome was reliant on self‐reported hypoglycaemia during weekly contact. While spontaneously self‐reported hypoglycaemia rates are low in people with Type 2 diabetes , self‐reported hypoglycaemia in response to questionnaires is a widely used measure of the true burden of hypoglycaemia in population studies . In retrospect, it would have been helpful to have collected data on rates of hypoglycaemia prior to the commencement of the intervention.…”

Section: Discussionmentioning

confidence: 99%

Intermittent fasting in Type 2 diabetes mellitus and the risk of hypoglycaemia: a randomized controlled trial

et al. 2018

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“…Recent evidence from Taiwan and Korea shows a worrying sharp rise in emergency admissions for hypoglycaemia in older patients, which further emphasizes the importance of our meta-analysis [24,25]. In addition, studies that used rigorous methods for ascertaining hypoglycaemia have found that the burden of hypoglycaemic events may be higher than envisaged [26,27] A number of mechanistic reasons have been identified to explain why hypoglycaemic events can lead to cognitive impairment (e.g. neuroglycopaenia).…”

Section: Discussionmentioning

confidence: 98%

Bi‐directional interaction between hypoglycaemia and cognitive impairment in elderly patients treated with glucose‐lowering agents: a systematic review and meta‐analysis

Mattishent

Loke

2015

Diabetes Obesity Metabolism

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Aims: Recent research suggests the possibility of a bi-directional relationship whereby hypoglycaemia is a risk factor for dementia, and also where dementia increases risk of hypoglycaemia. We aimed to examine this relationship in older patients with diabetes mellitus treated with glucose lowering agents. Materials and Methods:We searched MEDLINE and EMBASE over a ten year span 2005 to 2015 (with automated PubMed updates to August 2015) for observational studies of the association between hypoglycaemia and cognitive impairment or dementia in participants aged >55 years. Assessment of study validity was based on ascertainment of hypoglycaemia, dementia and risk of confounding. We conducted random effects inverse variance meta-analyses, and assessed heterogeneity using the I 2 statistic. Results:We screened 1177 citations, and selected twelve studies, with nine suitable for meta-analysis. There were a total of 1,439,818 participants, mean age 75 years. Meta-analysis of five studies demonstrated a significantly increased risk of dementia in patients who had hypoglycaemic episodes, pooled odds ratio of 1.68 (95% Confidence Interval 1.45, 1.95). We also found a significantly increased risk of hypoglycaemia in patients with dementia, pooled odds ratio from five studies 1.61 (95% Confidence Interval 1.25, 2.06).Limitations are heterogeneity in the meta-analysis, and uncertain ascertainment of dementia and hypoglycaemic outcomes and temporal relationships. Publication bias may favour reporting of more significant findings. Conclusions:Our meta-analysis demonstrates a bi-directional relationship between cognitive impairment and hypoglycaemia in older patients. Glucose 3 lowering therapy should be carefully tailored and monitored in older patients who are susceptible to cognitive decline.4

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Patient-reported frequency, awareness and patient-physician communication of hypoglycaemia in Belgium

Cited by 18 publications

References 23 publications

Self-reported frequency, severity of, and awareness of hypoglycemia in type 2 diabetes patients in Turkey

Self-reported frequency, severity of, and awareness of hypoglycemia in type 2 diabetes patients in Turkey

Intermittent fasting in Type 2 diabetes mellitus and the risk of hypoglycaemia: a randomized controlled trial

Bi‐directional interaction between hypoglycaemia and cognitive impairment in elderly patients treated with glucose‐lowering agents: a systematic review and meta‐analysis

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