title: Effects of patient-reported non-severe hypoglycemia on healthcare resource use, work-time loss, and wellbeing in insulin-treated patients with diabetes in seven European countries.
abstract: OBJECTIVE
  Hypoglycemia is a frequent side effect induced by insulin treatment of type 1 (T1DM) and type 2 diabetes (T2DM). Limited data exist on the associated healthcare resource use and patient impact of hypoglycemia, particularly at a country-specific level. This study investigated the effects of self-reported non-severe hypoglycemic events (NSHE) on use of healthcare resources and patient wellbeing.
  
  
  METHODS
  Patients with T1DM or insulin-treated T2DM diabetes from seven European countries were invited to complete four weekly questionnaires. Data were collected on patient demographics, NSHE occurrence in the last 7 days, hypoglycemia-related resource use, and patient impact. NSHE were defined as events with hypoglycemia symptoms, with or without blood glucose measurement, or low blood glucose measurement without symptoms, which the patient could manage without third-party assistance.
  
  
  RESULTS
  Three thousand, nine hundred and fifty-nine respondents completed at least one wave of the survey, with 57% completing all four questionnaires; 3827 respondents were used for data analyses. Overall, 2.3% and 8.9% of NSHE in patients with T1DM and T2DM, respectively, resulted in healthcare professional contact. Across countries, there was a mean increase in blood glucose test use of 3.0 tests in the week following a NSHE. Among respondents who were employed (48%), loss of work-time after the last hypoglycemic event was reported for 9.7% of NSHE. Overall, 10.2% (daytime) and 8.0% (nocturnal) NSHE led to work-time loss, with a mean loss of 84.3 (daytime) and 169.6 (nocturnal) minutes among patients reporting work-time loss. Additionally, patients reported feeling tired, irritable, and having negative feelings following hypoglycemia.
  
  
  CONCLUSIONS
  Direct comparisons between studies must be interpreted with caution because of different definitions of hypoglycemia severity, duration of the studies, and methods of data collection.
  
  
  CONCLUSIONS
  NSHE were associated with use of extra healthcare resources and work-time loss in all countries studied, suggesting that NSHE have considerable impact on patients/society.
authors.affiliation: Medical Centre Haaglanden , The Hague , Netherlands.
authors.forename: Petronella H
authors.initials: PH
authors.lastname: Geelhoed-Duijvestijn
authors.forename: Ulrik
authors.initials: U
authors.lastname: Pedersen-Bjergaard
authors.forename: Raimund
authors.initials: R
authors.lastname: Weitgasser
authors.forename: Jorma
authors.initials: J
authors.lastname: Lahtela
authors.forename: Marie Markert
authors.initials: MM
authors.lastname: Jensen
authors.forename: Claes-Göran
authors.initials: CG
authors.lastname: Östenson
mesh_terms: D015190:Blood Glucose Self-Monitoring / Q000706:statistics & numerical data; D017281:Cost of Illness; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000191:economics*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics*; D004651:Employment / Q000191:economics; D005060:Europe / Q000453:epidemiology; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007003:Hypoglycemia / Q000191:economics / Q000453:epidemiology; D057566:Self Report