title: Impact of hypoglycaemia on quality of life and productivity in type 1 and type 2 diabetes.
abstract: OBJECTIVE
  To characterise the impact of increasing severity and frequency of hypoglycaemia on utility, quality of life, primary care resource use and productivity (time away from normal activities) in people with both Type 1 and Type 2 diabetes.
  
  
  METHODS
  A postal survey was sent to 3200 people with diabetes. Self-reported episodes of mild, moderate, severe and nocturnal hypoglycaemia were quantified from a list of signs and symptoms. A number of instruments were used to explore the effect of frequency and severity of hypoglycaemia on quality of life and productivity.
  
  
  RESULTS
  There were 861 respondents for whom diabetes type was identifiable. Of these respondents, 629 (73%) experienced some form of hypoglycaemia, 516 (60%) non-exclusively experienced mild or moderate hypoglycaemia, 57 (7%) experienced severe hypoglycaemia and 191 (22%) experienced nocturnal hypoglycaemia. Quality of life and health-related utility decreased as the frequency and severity of hypoglycaemia increased. The use of primary care resources and lost productivity increased as the severity and frequency of hypoglycaemia increased. These associations were independent in multivariate analysis.
  
  
  CONCLUSIONS
  These findings suggest hypoglycaemia impacts heavily on the well-being, productivity and quality of life of people with diabetes, and that every effort should be made to minimise hypoglycaemia while aiming for good glycaemic control.
authors.affiliation: School of Care Sciences, University of Glamorgan, Pontypridd, Wales, United Kingdom.
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Davis
authors.forename: Malcolm
authors.initials: M
authors.lastname: Morrissey
authors.forename: John R
authors.initials: JR
authors.lastname: Peters
authors.forename: Kim
authors.initials: K
authors.lastname: Wittrup-Jensen
authors.forename: Tessa
authors.initials: T
authors.lastname: Kennedy-Martin
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Currie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003625:Data Collection; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D004526:Efficiency; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D006113:United Kingdom / Q000453:epidemiology