title: Self-reported frequency and impact of hypoglycemic events in Spain.
abstract: BACKGROUND
  Hypoglycemia is a common side effect of insulin therapy and has negative implications for quality of life and healthcare resources. The authors investigated the self-reported frequency of non-severe and severe hypoglycemic events (NSHEs and SHEs), hypoglycemia awareness, patient-physician communication, health-related effects and economic impact on people with insulin-treated diabetes (Type-1 and Type-2) in Spain.
  
  
  METHODS
  People with Type-1 (T1DM) or insulin-treated Type-2 (T2DM) diabetes older than 15 years of age completed up to 4 questionnaires at weekly intervals. NSHE was an event which respondents could manage without assistance. SHE needed help from a third party to manage.
  
  
  RESULTS
  In total, 630 respondents completed questionnaires covering 2,235 weeks. Mean self-reported NSHEs per respondent-week were 1.7 (T1DM) and 0.4-0.8 (T2DM). Impaired hypoglycemia awareness or unawareness was reported by 55% of T1DM and 39% of T2DM respondents. Overall, 31% of T1DM and 20% of T2DM respondents rarely/never informed their physician about NSHEs. Respondents reported feeling tired/fatigued after 67% of NSHE and less alert after 45% of NSHE. Over the week following an NSHE, blood glucose measurement test-strip use increased by 5.3 (mean). In employed respondents (43%), 18% of NSHEs were reported to lead to lost work time (mean 1.5 h per event). After an SHE, 49% of respondents required emergency visits and/or hospital admission.
  
  
  CONCLUSIONS
  NSHE are a common occurrence with T1DM and insulin-treated T2DM in Spain and are associated with a cost burden and negative impact on well-being. Patient-physician communication is higher in Spain than Europe overall; however, many patients expressed reluctance to discuss their hypoglycemia.
authors: Department of Clinical Medicine, University Miguel Hernández, Alicante, Spain, dorozcobeltran@gmail.com.
authors: Domingo
authors: D
authors: Orozco-Beltrán
authors: Pedro
authors: P
authors: Mezquita-Raya
authors: Antonio
authors: A
authors: Ramírez de Arellano
authors: Manuel
authors: M
authors: Galán