LMC Diabetes and Endocrinology, Toronto, Canada.
Endocrinology Research Center, Moscow, Russian Federation.
Diabetes Res Clin Pract. 2018 Apr;138:35-43. doi: 10.1016/j.diabres.2018.01.007. Epub 2018 Jan 31.
The Hypoglycaemia Assessment Tool (HAT) study investigated the health economic impact of hypoglycaemic events in 24 countries, including countries without previously published data on hypoglycaemia.
Self-assessment questionnaires and patient diaries (4-week prospective period) were completed by adults with type 1 (T1D) or type 2 diabetes (T2D) treated with insulin for more than 12 months (N = 27,585).
Direct economic impacts of hypoglycaemia during the 4-week prospective period, included increased blood glucose monitoring (reported by 69.7% [T1D] and 60.9% [T2D] of patients), hospitalisation (T1D 2.1%; T2D 3.4% of patients) and medical contact (clinic or telephone; T1D 3.8%; T2D 6.8% of patients). Regional variation in medical contact and hospitalisation was found, with the highest usage in Russia (T1D 17.1%; T2D 17.3%), and Latin America (T1D 5.2%; T2D 6.8%) respectively. Indirect economic impacts following hypoglycaemia included loss of productivity due to absence from work or study; 3.9% (T1D) and 6.2% (T2D) of patients. Regional differences in work productivity were noted among patients with T2D, with a low prevalence in Northern Europe and Canada (0.9%) and high in Southeast Asia (14.6%).
This study shows that hypoglycaemia has a significant but variable impact on the economics of diabetes healthcare globally.
低血糖评估工具 (HAT) 研究调查了 24 个国家低血糖事件对健康经济的影响,其中包括以前没有发表过低血糖数据的国家。
1 型 (T1D) 或 2 型 (T2D) 糖尿病患者接受胰岛素治疗超过 12 个月(N=27585)完成自我评估问卷和患者日记(4 周前瞻性时期)。
4 周前瞻性期间低血糖的直接经济影响包括增加血糖监测(T1D 患者报告的比例为 69.7%,T2D 为 60.9%)、住院(T1D 为 2.1%;T2D 为 3.4%的患者)和医疗接触(诊所或电话;T1D 为 3.8%;T2D 为 6.8%的患者)。发现医疗接触和住院存在区域差异,俄罗斯(T1D 为 17.1%;T2D 为 17.3%)和拉丁美洲(T1D 为 5.2%;T2D 为 6.8%)的使用率最高。低血糖后还存在间接经济影响,包括因缺勤而导致的生产力损失;T1D 为 3.9%,T2D 为 6.2%的患者。还注意到 T2D 患者的工作生产力存在区域差异,北欧和加拿大的患病率较低(0.9%),东南亚较高(14.6%)。
这项研究表明,低血糖对全球糖尿病医疗保健的经济具有重大但不同的影响。