Self-reported experience of hypoglycemia among adults with type 2 diabetes mellitus (Exhype)

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

doi:10.1016/j.diabres.2010.12.005

Cited by 28 publications

(32 citation statements)

References 21 publications

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“…The study design has been published previously,24 and was essentially of a national, cross-sectional, and multicenter nature. Patients were on stable doses of metformin and sulfonylureas for at least 6 months prior to enrollment and were recruited consecutively from 54 locations in all of Sweden’s 21 county councils by their general practitioners between January and August 2009 (Figure 1).…”

Section: Methodsmentioning

confidence: 99%

“…The patients were asked to complete three questionnaires, ie, the Experiences of Hypoglycemia, Self-Reported Adherence and Barriers, and Treatment Satisfaction Questionnaire for Medication (TSQM). Primary care physicians completed a web-based case report form 24. The study protocol was approved in October 2008 by the Regional Ethical Review Board in Linköping (M185-08).…”

Section: Methodsmentioning

confidence: 99%

“…Mild symptoms were defined as causing “little or no interruption of activities, without need of assistance to manage symptoms,” moderate symptoms were classified as “some interruption of activities, but without need of assistance to manage symptoms,” severe symptoms were described as “interruption of activities with need of assistance from others to manage symptoms,” and very severe symptoms were defined as “interruption of activities with need of medical attention.” 24,25…”

Section: Methodsmentioning

confidence: 99%

“…Group categorization was based on patient experiences of interruption of their activities due to symptoms of hypoglycemia, which is consistent with the definition used in a recent Cochrane review, where hypoglycemia was categorized as mild (controlled by patient), moderate (daily activities interrupted but self-managed), or severe (requiring assistance) 13. We dichotomized the group according to perceived interruption of activities; those who had no or mild symptoms of hypoglycemia (no activities interrupted) and those who had moderate or worse symptoms (activities interrupted), because there is evidence that quality of life is lower in patients with moderate or worse symptoms than among those with no or mild symptoms 24. Our hypothesis was that moderate and worse symptoms of hypoglycemia affect the patient’s preferences and adherence in much the same way.…”

Section: Methodsmentioning

confidence: 99%

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

Walz¹,

Pettersson²,

Rosenqvist³

et al. 2014

PPA

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BackgroundThe 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.MethodsThis 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.ResultsPatients 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).ConclusionSymptomatic 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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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

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

Walz¹,

Pettersson²,

Rosenqvist³

et al. 2014

PPA

Self Cite

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show abstract

“…In the study by Lundqvist [8], hypoglycemia was verified with a blood glucose test. This raised the question as to whether the participants in the present study, and in the study by Pettersson et al [17], were really convinced that they had had hypoglycemia. Some participants treated by only diet and exercise or metformin experienced hypoglycemia, and these findings require further attention, as self-reported hypoglycemia may be confused with other health problems such as anxiety [9].…”

Section: Information About Hypoglycemiamentioning

confidence: 51%