Harris Stewart B, Khunti Kamlesh, Landin-Olsson Mona, Galbo-Jørgensen Claus B, Bøgelund Mette, Chubb Barrie, Gundgaard Jens, Evans Marc
Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Patient Prefer Adherence. 2013 Sep 16;7:925-36. doi: 10.2147/PPA.S46805. eCollection 2013.
We sought to develop descriptions of health states associated with daytime and nocturnal hypoglycemia in a structured fashion from the patient's perspective under different combinations of severity and frequency of hypoglycemic events.
An expert meeting followed by two patient focus groups was used to develop comprehensive descriptions of acute consequences of severe and non-severe, daytime and nocturnal hypoglycemia. Patients with diabetes (type 1 = 85, type 2 = 162) from a survey panel then validated these descriptions and assessed how often they worried and took different actions to prevent hypoglycemia. Severity and frequency of hypoglycemia were compared with respect to how often people worried and took actions to prevent an event. The effect of hypoglycemia on 35 different life activities was quantitatively compared for patients who had and had not experienced a severe hypoglycemic event.
At least 95% of respondents agreed that the detailed patient-level descriptions of health states accurately reflected their experience of severe and non-severe, daytime and nocturnal hypoglycemia, thereby validating these descriptions. Respondents who had experienced a severe hypoglycemic event were generally more adversely affected in their worries and actions and life events than those who experienced only non-severe events; those who experienced nocturnal events were more affected than those who experienced only daytime events.
The negative psychosocial consequences and undesirable compensatory behaviors arising from hypoglycemia underscore the importance of preventing severe episodes, particularly severe nocturnal episodes. These validated descriptions for hypoglycemia from the patient's perspective may also help inform future qualitative and quantitative research.
我们试图从患者的角度，以结构化的方式，针对低血糖事件的严重程度和频率的不同组合，来描述与日间和夜间低血糖相关的健康状态。
通过一次专家会议和两个患者焦点小组，来全面描述严重和非严重的日间及夜间低血糖的急性后果。然后，来自一个调查小组的糖尿病患者（1型糖尿病患者85名，2型糖尿病患者162名）对这些描述进行验证，并评估他们担心低血糖的频率以及采取不同预防措施的情况。就人们担心和采取预防措施的频率而言，对低血糖的严重程度和频率进行了比较。对经历过和未经历过严重低血糖事件的患者，定量比较了低血糖对35种不同生活活动的影响。
至少95%的受访者同意，对健康状态的详细患者层面描述准确反映了他们严重和非严重的日间及夜间低血糖经历，从而验证了这些描述。经历过严重低血糖事件的受访者在担忧、行为和生活事件方面，通常比仅经历过非严重事件的受访者受到的负面影响更大；经历过夜间低血糖事件的受访者比仅经历过日间低血糖事件的受访者受到的影响更大。
低血糖产生的负面心理社会后果和不良代偿行为凸显了预防严重发作，尤其是严重夜间发作的重要性。这些从患者角度对低血糖的经过验证的描述，也可能有助于为未来的定性和定量研究提供信息。
