The effect of hypoglycemia on health-related quality of life: Canadian results from a multinational time trade-off survey.
OBJECTIVE
The aim of this study was to investigate the impact of hypoglycemia according to severity and time of onset on health-related quality of life (HRQoL) in a Canadian population.


METHODS
Time trade-off (TTO) methodology was used to estimate health utilities associated with hypoglycemic events in a representative sample of the Canadian population. A global analysis conducted in the United Kingdom, Canada, Germany and Sweden has been published. The present Canadian analysis focuses on 3 populations: general, type 1 and type 2 diabetes. Using a web-based survey, participants (>18 years) assessed the utility of 13 different health states (severe, non-severe, daytime and nocturnal hypoglycemia at different frequencies) using a scale from 1 (perfect health) to 0 (death). The average disutility value for each type of event was calculated.


RESULTS
Of 2258 participants, 1696 completers were included in the analysis. A non-severe nocturnal hypoglycemic event was associated with a significantly greater disutility than a non-severe daytime event (-0.0076 vs. -0.0056, respectively; p=0.05), while there was no statistically significant difference between severe nocturnal and severe daytime events (-0.0616 vs. -0.0592; p=0.76). Severe hypoglycemia was associated with greater disutility than non-severe hypoglycemia (p<0.0001). Similar trends were reported in participants with diabetes.


CONCLUSIONS
The findings presented here show that any form of hypoglycemia had a negative impact on HRQoL in a Canadian population. Nocturnal and/or severe hypoglycemia had a greater negative impact on HRQoL compared with daytime and/or non-severe events. This highlights the importance of preventing the development and nocturnal manifestation of hypoglycemia in patients with diabetes.
Department of Family Medicine, Western University, London, Ontario, Canada. Electronic address: sharris1@uwo.ca.
Stewart
S
Harris
Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Institute of Health Policy, Management, and Evaluation and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Muhammad
M
Mamdani
Incentive Partners, Holte, Denmark.
Claus B
CB
Galbo-Jørgensen
Incentive Partners, Holte, Denmark.
Mette
M
Bøgelund
Novo Nordisk A/S, Søborg, Denmark.
Jens
J
Gundgaard
Novo Nordisk Canada Inc, Mississauga, Ontario, Canada.
Danielle
D
Groleau
D000328:Adult; D002170:Canada; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D007003:Hypoglycemia / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires
Canada; diabetes mellitus; diabète sucré; hypoglycemia; hypoglycémie; quality of life; qualité de vie; théorie de l’utilité; utility theory