A global perspective on the impact of hypoglycaemia

A new multi-country study examines the impact of hypoglycaemia among adults with insulin-treated diabetes. 

by Dr Elizabeth Homles-Truscott


A new study, published here in Diabetes Research and Clinical Practice by Prof Kamlesh Khunti and colleagues, investigates the impact of hypoglycaemia among adults with type 1 diabetes and insulin-treated type 2 diabetes. This large-scale study, involving 27,585 participants in 24 countries, is the first of its kind to investigate fear of, and responses to, hypoglycaemia on a global level, including disparities between regions.

The study draws on a subset of clinical and self-report data from an observational, prospective study of hypoglycaemia in clinical practice. Participants tracked their hypoglycaemia experiences in a diary over a 4-week period. They also reported their fear of hypoglycaemia, actions as a result of a hypoglycaemic episode, and the impact of hypoglycaemia on work or study, by diabetes type and region.

Approximately 7% of participants overall reported their level of fear of hypoglycaemia as ‘absolutely terrified’. Consistent with prior research, fear of hypoglycaemia was higher among participants who reported a history of severe hypoglycaemia (12% were ‘absolutely terrified’). Overall, increased blood glucose monitoring was the most common action taken in the 4 weeks following hypoglycaemic events. Participants with type 1 diabetes were more likely to reduce their insulin dose, while participants with insulin-treated type 2 diabetes were more likely to consult their health professional or require medical assistance in response to a hypoglycaemic event. During the 4-week study period, 5-6% of participants took leave from work or study (2 days on average) due to hypoglycaemia.

Fear of, and responses to, hypoglycaemia differed by region, with participants from Northern Europe and Canada reporting lower fear of hypoglycaemia and utilisation of healthcare resources. Interestingly, the regions in which higher average fear of hypoglycaemia was reported were not necessarily the regions with the highest rates of hypoglycaemia. The authors argued that the marked regional differences in the management and perceived impact of hypoglycaemia highlight the need for the regional data collection to inform local interventions and health care.

Khunti K, Alsifri S, Aronson R, Berković MC, Enters-Weijnen C, Forsén T, Galstyan G, Geelhoed-Duijvestijn P, Goldfracht M, Gydesen H, Kapur R. (2017) Impact of hypoglycaemia on patient-reported outcomes from a global, 24-country study of 27,585 people with type 1 and insulin-treated type 2 diabetesDiabetes Research and Clinical Practice. 130:121-9.