Shafie Asrul Akmal, Ng Chin Hui, Thanimalai Subramaniam, Haron Norliza, Manocha Anita Bhajan
1Discipline of Social & Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), 11800 Penang, Malaysia.
2Ministry of Health, Putrajaya, Malaysia.
J Diabetes Metab Disord. 2018 Nov 7;17(2):269-275. doi: 10.1007/s40200-018-0369-z. eCollection 2018 Dec.
The primary objective of this study was to estimate the health utility values for hypoglycaemia events according to their severity and frequency. The secondary objective was to compare the health utilities between those with Type 2 Diabetes Mellitus and the general population.
The health utilities of hypoglycaemia event were measured using Visual Analogue Scale (VAS) and Time Trade-Off (TTO) methods among conveniently sampled consenting adults (>18 years and literate in either English or Malay language), which were then divided into two groups: those in the general population (GP) and those with Type 2 Diabetes Mellitus (T2DM). Each respondent was required to value 13 different health states, including frequencies of daytime hypoglycaemia and nocturnal hypoglycaemia, each depending on its severity (non-severe or severe).
256 respondents from the GP and 99 respondents with T2DM completed the survey. The T2DM group gave higher VAS-values compared to the GP group. The highest mean VAS-utility value for non-severe nocturnal hypoglycaemia occurring once monthly was 0.543 (SD 0.161), and for severe daytime hypoglycaemia occurring once quarterly was 0.293 (SD 0.162) which was the lowest utility value compared to other health states. However, non-severe nocturnal hypoglycaemia occurring once quarterly was 0.537 (SD 0.284) and has the highest TTO-utility value. Severe nocturnal hypoglycaemia occurring once quarterly has the lowest utility value which was -0.104 (SD 0.380). Daytime hypoglycaemia has lower utility value compared to nocturnal hypoglycaemia. Severe hypoglycaemia has a greater disutility compared with the non-severe hypoglycaemia in both studied groups.
The findings show that as a health utility, hypoglycaemia has a substantial impact on utility with severe hypoglycaemia having a greater negative impact compared to non-severe events across the board. This highlights the importance of preventing development of severe hypoglycaemia in patients with Type 2 Diabetes Mellitus at any time of the day.
本研究的主要目的是根据低血糖事件的严重程度和发生频率估算其健康效用值。次要目的是比较2型糖尿病患者与普通人群之间的健康效用。
在方便抽样的同意参与的成年人（年龄>18岁，会英语或马来语）中，使用视觉模拟量表（VAS）和时间权衡（TTO）方法测量低血糖事件的健康效用，这些成年人随后被分为两组：普通人群（GP）和2型糖尿病患者（T2DM）。每位受访者需要对13种不同的健康状态进行评估，包括白天低血糖和夜间低血糖的发生频率，每种频率又取决于其严重程度（非严重或严重）。
来自普通人群的256名受访者和99名2型糖尿病患者完成了调查。2型糖尿病组的VAS值高于普通人群组。每月发生一次的非严重夜间低血糖的最高平均VAS效用值为0.543（标准差0.161），每季度发生一次的严重白天低血糖的最高平均VAS效用值为0.293（标准差0.162），与其他健康状态相比，该值是最低的效用值。然而，每季度发生一次的非严重夜间低血糖的VAS效用值为0.537（标准差0.284），且具有最高的TTO效用值。每季度发生一次的严重夜间低血糖的效用值最低，为-0.104（标准差0.380）。与夜间低血糖相比，白天低血糖的效用值更低。在两个研究组中，严重低血糖比非严重低血糖具有更大的负效用。
研究结果表明，作为一种健康效用，低血糖对效用有重大影响，与非严重低血糖事件相比，严重低血糖在总体上具有更大的负面影响。这突出了在2型糖尿病患者的一天中的任何时候预防严重低血糖发生的重要性。
