How do hypoglycaemias affect the everyday life of people with diabetes and are they able to treat them adequately?

AIMS

To investigate whether people with type 1 and type 2 diabetes respond adequately to hypoglycaemia symptoms after participating in a treatment and teaching programme. Additionally, it explored how hypoglycaemia impacts patients' everyday life and the differences between individuals with and without impaired awareness of hypoglycaemia (IAH).

METHODS

This cross-sectional study included 340 adult participant with type 1 (n = 156) or type 2 diabetes (n = 184) undergoing insulin therapy at the University Hospital Jena. Participants completed validated questionnaires and participated in structured interviews about hypoglycaemia. Awareness of hypoglycaemia was measured using the Gold Score, and diabetes distress with the PAID Scale (PAID Score 0-100, the higher the score the higher the distress).

RESULTS

23.8% of the participants treated hypoglycaemia adequately (type 1 diabetes 27.6% vs. type 2 diabetes 24.7%; p = 0.606). Significantly more people without IAH-treated hypoglycaemia adequately in type 2 (27.9% vs. 10.3%; p = 0.047) but not in type 1 diabetes (28.6% vs. 23.1%; p = 0.568). Hypoglycaemia altered daily routines for 26.2% of participants, particularly those with type 1 diabetes (type 1 diabetes 37.3% vs. type 2 diabetes 20.1%; p = 0.001). People with type 1 and type 2 diabetes reporting changes in daily routines had higher diabetes distress scores (PAID: 22.3 ± 16.0 vs. 13.8 ± 13.5; p < 0.001). Fear of hypoglycaemia was associated with higher HbA values due to people accepting elevated blood glucose levels.

CONCLUSIONS

Despite education programmes, the majority of participants do not treat hypoglycaemia adequately. Hypoglycaemic events significantly impact daily life and are associated with increased diabetes-related distress, especially in those with IAH.