Strategic Affairs Department, LifeScan UK Ltd., Johnson & Johnson, High Wycombe, UK.
Expert Rev Pharmacoecon Outcomes Res. 2013 Feb;13(1):123-30. doi: 10.1586/erp.12.80.
Hypoglycemia is common in patients with diabetes, and any severe hypoglycemic event can increase the fear of future hypoglycemic events. To try to reduce hypoglycemic events, many patients with diabetes maintain their blood glucose levels with a 'safety margin' (i.e., at higher than recommended values) and maintain hyperglycemia. Following this strategy leads to raised glycated hemoglobin levels, which are, consequently, linked to an increased risk of diabetic complications and increased healthcare costs. In the present survey (n = 1848), conducted in Germany, France and the UK, approximately a third of the patients were very worried about hypoglycemia, and a similar proportion reported maintaining hyperglycemia. Overall, the mean number of emergency room visits and hospitalizations (excluding emergency room visits) per patient per 12 months was 0.65 and 0.47, respectively. In addition, 10% of the patients reported that they had taken days off work because of hypoglycemia during the previous 12 months. Furthermore, 80% of diabetics in the three countries said they would value a meter that tells them when their blood glucose level is getting high/low at a particular time of the day. Thus, the survey outlines the potential scale, in a real-world setting, of 'hidden' costs associated with hypoglycemia and fear of hypoglycemia; such costs are likely to have a major detrimental impact on the overall emotional and economic burden of diabetes, which may be reduced through broader use of blood-glucose monitors for self-monitoring of blood glucose.
低血糖在糖尿病患者中很常见,任何严重的低血糖事件都可能增加对未来低血糖事件的恐惧。为了尽量减少低血糖事件,许多糖尿病患者通过“安全边际”(即高于推荐值)来控制血糖水平,并维持高血糖。这种策略会导致糖化血红蛋白水平升高,从而增加患糖尿病并发症的风险和增加医疗保健费用。在本调查(n=1848)中,在德国、法国和英国进行,约三分之一的患者非常担心低血糖,并且有类似比例的患者报告说维持高血糖。总体而言,每位患者每 12 个月因低血糖急诊就诊和住院(不包括急诊就诊)的平均次数分别为 0.65 次和 0.47 次。此外,10%的患者报告说,在过去 12 个月中,由于低血糖,他们请过病假。此外,这三个国家的 80%的糖尿病患者表示,他们希望有一种血糖仪,可以在一天中的特定时间告诉他们血糖水平高低。因此,该调查概述了低血糖和对低血糖的恐惧相关“隐性”成本在现实环境中的潜在规模;这些成本可能会对糖尿病的整体情感和经济负担产生重大不利影响,而通过更广泛地使用血糖仪来自我监测血糖水平,可能会减轻这种负担。