Self-reported Hypoglycaemic Events in 2 430 Patients with Insulin-treated Diabetes in the German Sub-population of the HAT Study

Abstract

Data concerning true hypoglycaemic incidence in insulin-treated patients with diabetes in real-world clinical practice are lacking in Germany. The aim of this analysis was to determine the incidence of hypoglycaemia experienced by the German cohort of patients enrolled in the global Hypoglycaemia Assessment Tool (HAT) study. This was a non-interventional, 6-month retrospective and 4-week prospective study using self-assessment questionnaires and patient diaries assessing patients aged ≥18 years in Germany, with type 1 diabetes (T1D) (n=811) or type 2 diabetes (T2D) (n=1 619) treated with insulin for >12 months. The primary endpoint was the percentage of patients experiencing ≥1 hypoglycaemic event during the prospective observational period (4 weeks after baseline). Predictive and continuous factors (such as age, gender, duration of insulin use and HbA1c) contributing to hypoglycaemia risk were explored.During the prospective period, at least one hypoglycaemic event was reported by 81.3% of patients with T1D and 39.7% of patients with T2D, indicating that hypoglycaemia is a common acute complication among patients with insulin-treated diabetes. Severe hypoglycaemia was reported by 9.1% of patients with T1D and 5.4% of patients with T2D. Higher rates of any and severe hypoglycaemia were reported prospectively than retrospectively, regardless of diabetes type, indicating that patients retrospectively under-report hypoglycaemia. Prospective rates (events per patient-year) of any, nocturnal and severe hypoglycaemia were 80.3, 9.9 and 3.0 for T1D and 15.6, 2.4 and 1.1 for T2D, respectively. Given the potential for recall bias in retrospective reporting, this prospective assessment of hypoglycaemia appears more reliable than retrospective assessment. Trial number: NCT01696266

Conversations and Reactions Around Severe Hypoglycaemia (CRASH): Results from the German Cohort of a Global Survey of People with Type 1 Diabetes or Insulin-Treated Type 2 Diabetes and Caregivers

“…quency with which glucagon was recommended to T1D PWD and T2D PWD, a finding that may reflect an underestimation of the risk of severe hypoglycaemia in insulin-treated patients with T2D. Although the risk of severe hypoglycaemia is undoubtedly lower in insulin-treated patients with T2D than in those with T1D [4], it remains substantial. For example, in the German cohort of the Hypoglycaemia Assessment Tool (HAT) study -in which real-world data were collected from insulin-treated patients with T1D or T2D -5.4 % of patients with T2D experienced severe hypoglycaemia vs 9.1 % of those with T1D during a 4-week prospective data collection period [4].…”

“…Although the risk of severe hypoglycaemia is undoubtedly lower in insulin-treated patients with T2D than in those with T1D [4], it remains substantial. For example, in the German cohort of the Hypoglycaemia Assessment Tool (HAT) study -in which real-world data were collected from insulin-treated patients with T1D or T2D -5.4 % of patients with T2D experienced severe hypoglycaemia vs 9.1 % of those with T1D during a 4-week prospective data collection period [4]. Our data show that more than one-quarter of the T1D and T2D CRASH participants -all of whom were insulin treated and had experienced at least one severe hypoglycaemia episode within the past 3 years -had in fact experienced two or more severe hypoglycaemic events in the past 12 months.…”

Effects of Guided Reflection on Diabetes Self-Care: A Randomized Controlled Trial

“…Diabetes-related events identified by the participants in this study are consistent with previous studies. 14,15,48 An awareness of the types of DM-related situations participants choose to reflect upon as they engage in self-care is critical to the development of appropriate nursing interventions to address the needs of this population.…”

Hundert Jahre – Insulin bleibt aktuell und notwendig

“…Das Hypoglykämierisiko ist bei Menschen mit einem Typ-1-Diabetes höher als bei Individuen mit einem Typ-2-Diabetes, obgleich Prävalenz und Inzidenz von Hypoglykämien bei Menschen mit Typ-2-Diabetes häufig unterschätzt werden [106][107][108][109][110].…”