Four out of five (80%) people with type 2 diabetes have experienced self-treated hypoglycaemia, with 36% experiencing an hypoglycaemic episode in the last month, a new global survey has found. (Self-treated hypoglycaemia is an event caused by low blood sugar levels which people with diabetes can treat themselves and which does not require medical assistance.)
According to the Global Attitudes of Patients and Physicians (GAPP2™) survey, funded by Novo Nordisk and presented on Friday at the Annual Meeting of the European Association for the Study of Diabetes (EASD), these hypoglycaemic episodes also affected the way that patients with type 2 diabetes managed their condition.
Not taking insulin as prescribed
Nearly half (46%) of the patients in the study reported increasing blood glucose monitoring as a result of their last episode and more than one in 10 altered their long-acting insulin regime. In addition, according to the GAPP2™ survey, 16% of people with type 2 diabetes said they had intentionally not taken their insulin as prescribed and 14% had intentionally kept their blood sugar at a higher than recommended level in order to avoid hypoglycaemia during the night.
Healthcare professionals also said that their prescribing decisions were influenced by the risk of self-treated hypoglycaemia. When deciding the type of insulin to prescribe, 82% took the risk of hypoglycaemia into account and more than half (57%) started patients on a lower dose of long-acting insulin than recommended.
"Self-treated hypoglycaemia represents a significant clinical challenge in type 2 diabetes, influencing both patient and prescriber behaviours in insulin management," said lead researcher and health psychologist Dr Meryl Brod of The Brod Group, Mill Valley, USA. "Less than optimal patient responses to self-treated hypoglycaemia and non-adherent behaviour need to be addressed to improve glycaemic control and patient welfare."
Insulin non-adherence [when the patient does not take their insulin as prescribed] can negatively impact blood sugar control and lead to complications and death. Furthermore, new data from the GAPP2™ survey confirmed that regardless of hypoglycaemia, dosing irregularities of long-acting insulin remain common. However, while patients recognised the clinical consequences of this behaviour, a substantial proportion still intentionally did not take their insulin as prescribed.
77% of patients who had reduced a basal insulin dose admitted that on the last occasion they had done so deliberately
63% of patients believed missing doses of basal insulin would have a negative impact on their long-term health
37% said they would feel guilty if they missed a long-acting insulin dose
48% of patients said they had missed a dose of basal insulin altogether
51% said they had mistimed a basal dose by more than two hours
38% said they had reduced a dose of basal insulin
Maintaining optimal glycaemic control is important because it helps reduce long-term complications for diabetic patients. Symptoms of a hypoglycaemic event (when blood sugar becomes too low) often include a pounding heart, trembling, hunger, sweating, difficulty concentrating or confusion.
Initial GAPP2™data were presented at the Scientific Sessions of the American Diabetes Association (ADA) earlier this year. The full data set will be published by the end of 2012.
Novo Nordisk press release
- (Health24, October 2012)
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