title: Understanding the economic, daily functioning, and diabetes management burden of non-severe nocturnal hypoglycemic events in Canada: differences between type 1 and type 2.
abstract: OBJECTIVE
  To examine the daily functioning, diabetes management, and economic burden of non-severe nocturnal hypoglycemic events (NSNHEs) in Canada and differences in impacts by diabetes type.
  
  
  METHODS
  A 20-min web-based survey, with items derived from the literature, expert and patient interviews, assessing the impact of NSNHEs, was administered to patients with self-reported diabetes aged ≥18 having an NSNHE in the past month.
  
  
  RESULTS
  Two thousand, two hundred and seventy-nine Canadian persons with diabetes were screened with 200 respondents meeting criteria and included in the analysis sample. Out of 87 working respondents, 15 reported on average 3.5 h of lost work (absenteeism). The reduction in work productivity (presenteeism) reported was comparable to the impact of arthritis. Other functional impacts included sleep and daily activities. Additionally, respondents' increased their usual blood sugar monitoring practice, on average, 4.2 (SD = 7.5) extra tests were conducted in the week following the event and reduced their insulin over the following 4.8 days. Increased healthcare utilization was also reported. Increased costs as a result of NSNHE for lost work productivity, increased diabetes management, and resource utilization was CAD 70.67 per person per year in this sample. Limitations of the study include the biases which are associated with a web-based survey and self-reported data.
  
  
  CONCLUSIONS
  NSNHEs have serious consequences for patients and diabetes management practices. Greater attention to treatments which reduce NSNHEs can have a major impact on improving functioning while reducing the economic burden of diabetes.
authors.affiliation: The Brod Group , Mill Valley, CA , USA.
authors.forename: Meryl
authors.initials: M
authors.lastname: Brod
authors.forename: Michael
authors.initials: M
authors.lastname: Wolden
authors.forename: Danielle
authors.initials: D
authors.lastname: Groleau
authors.forename: Donald M
authors.initials: DM
authors.lastname: Bushnell
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D017281:Cost of Illness; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology* / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D006306:Health Surveys; D006801:Humans; D007003:Hypoglycemia / Q000191:economics*; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D055815:Young Adult