Frier B M, Jensen M M, Chubb B D
The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.
Novo Nordisk Scandinavia AB, Copenhagen, Denmark.
Diabet Med. 2016 Aug;33(8):1125-32. doi: 10.1111/dme.12878. Epub 2015 Sep 7.
Few real-life studies of non-severe (self-treated) hypoglycaemic events are available. This survey quantified the self-reported frequency of non-severe hypoglycaemia and its effects in adults with insulin-treated diabetes in the UK.
Adults aged > 15 years with Type 1 diabetes or insulin-treated Type 2 diabetes completed ≤ 4 weekly questionnaires (7-day recall). Respondents with Type 2 diabetes were grouped by insulin regimen: basal-only, basal-bolus and 'other'.
Overall, 1038 respondents (466 with Type 1 diabetes, 572 with Type 2 diabetes) completed 3528 questionnaires. Mean numbers of non-severe events per week were 2.4 (Type 1 diabetes; median = 2) and 0.8 (Type 2 diabetes; median = 0); 23% and 26% of non-severe events occurred at night, respectively. Fatigue and reduced alertness were the commonest issues following events (78% and 51% of respondents, respectively). The effects of nocturnal events persisted longer than those of daytime events: Type 1 diabetes = 10.6 vs. 4.9 h (P = 0.0002); Type 2 diabetes = 15.3 vs. 5.1 h (P < 0.0001). In the week following an event, respondents' blood glucose measurements increased by 4.3 (Type 1 diabetes; 12% increment) and 4.2 (Type 2 diabetes; 21% increment) tests/week. In employed respondents, 20% of events caused work-time loss, more so following nocturnal (vs. daytime) hypoglycaemia: Type 1 diabetes = 2.7 vs. 1.1 h (P = 0.0184); Type 2 diabetes = 2.5 vs. 1.6 h (P = 0.1340). Most respondents rarely/never informed healthcare professionals about events (Type 1 diabetes = 82%, Type 2 diabetes = 69%).
Non-severe hypoglycaemia is common in adults with insulin-treated diabetes in the UK, with consequent health-related/economic effects. Communication about non-severe hypoglycaemia is limited and the burden of hypoglycaemia may be underestimated.
关于非严重(自我治疗)低血糖事件的实际研究较少。本调查对英国胰岛素治疗的糖尿病成年患者自我报告的非严重低血糖发生频率及其影响进行了量化。
年龄大于15岁的1型糖尿病或胰岛素治疗的2型糖尿病成年患者完成了≤4份每周一次的问卷(7天回忆法)。2型糖尿病患者按胰岛素治疗方案分组:仅基础胰岛素治疗、基础-餐时胰岛素治疗和“其他”。
总体而言,1038名受访者(466名1型糖尿病患者,572名2型糖尿病患者)完成了3528份问卷。每周非严重低血糖事件的平均次数分别为2.4次(1型糖尿病;中位数=2)和0.8次(2型糖尿病;中位数=0);非严重低血糖事件分别有23%和26%发生在夜间。疲劳和警觉性下降是事件发生后最常见的问题(分别占受访者的78%和51%)。夜间低血糖事件的影响持续时间比白天事件更长:1型糖尿病分别为10.6小时和4.9小时(P=0.0002);2型糖尿病分别为15.3小时和5.1小时(P<0.0001)。在事件发生后的一周内,受访者的血糖检测次数每周增加4.3次(1型糖尿病;增加12%)和4.2次(2型糖尿病;增加21%)。在有工作的受访者中,20%的低血糖事件导致工作时间损失,夜间(与白天相比)低血糖事件导致的工作时间损失更多:1型糖尿病分别为2.7小时和1.1小时(P=0.0184);2型糖尿病分别为2.5小时和1.6小时(P=0.1340)。大多数受访者很少/从未将低血糖事件告知医护人员(1型糖尿病患者占82%,2型糖尿病患者占69%)。
在英国,非严重低血糖在胰岛素治疗的糖尿病成年患者中很常见,会产生与健康相关的/经济方面的影响。关于非严重低血糖的沟通有限,低血糖的负担可能被低估。