A cross-sectional survey among patients and prescribers on insulin dosing irregularities and impact of mild (self-treated) hypoglycemia episodes in Spanish patients with type 2 diabetes as compared to other European patients.
OBJECTIVE
In Spain, data suggest that 13.8% of adults have diabetes. Two important aspects in diabetes management are mild hypoglycemic episodes and poor treatment adherence. This study assesses the impact of missed insulin doses and prevalence of mistimed and reduced insulin doses and mild hypoglycemia in patients with type 2 diabetes treated with basal insulin analogues in Spain, and compares the data collected to pooled data from 8 other European countries (OECs).


METHODS
GAPP2 was an international, online, cross-sectional study of diabetic patients aged ≥40 years treated with long-acting insulin analogues and their healthcare professionals. Patients and healthcare professionals were recruited from online research panels. Data reported in Spain are compared to pooled data from 8 OECs.


RESULTS
In Spain, 1-3% of patients reported they had reduced, missed, or mistimed at least one insulin does in the previous month. Significantly more OEC patients reported dosing irregularities (15-23%; all P<0.01). In Spain, 77% of patients were worried and 59% felt guilty for missing a dose of basal insulin, while 24% reported that they were very worried about nocturnal hypoglycemia. Significantly fewer OEC patients reported worrying (47%; P<0.01) and feeling guilty (37%; P<0.01) about missing an insulin dose, or worry about nocturnal hypoglycemia (12%; P<0.01).


CONCLUSIONS
In Spain, patients with type 2 diabetes report fewer dosing irregularities and hypoglycemic episodes as compared to patients from OECs. However, Spanish patients appear to have a reduced quality of life related to hypoglycemia as well as worry and guilt related to insulin dosing irregularities.
Diabetes Reference Unit, Endocrinology and Nutrition Department, Clinic University Hospital, Valencia, Spain. Electronic address: francisco.j.ampudia@uv.es.
Francisco J
FJ
Ampudia-Blasco
Novo Nordisk, Madrid, Spain.
Manuel
M
Galán
The Brod Group, Mill Valley, CA, USA.
Meryl
M
Brod
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005060:Europe; D005260:Female; D006282:Health Personnel; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage* / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D012648:Self Care; D012720:Severity of Illness Index; D013030:Spain; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
D007004:Hypoglycemic Agents; D007328:Insulin
Diabetes tipo 2; Dosing irregularities; Encuesta GAPP2; GAPP 2 survey; Hipoglucemia; Hypoglycemia; Insulin; Insulina; Irregularidades en dosificación; Type 2 diabetes