Real-world crude incidence of hypoglycemia in adults with diabetes: Results of the InHypo-DM Study, Canada.

Autor: Ratzki-Leewing A; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada., Harris SB; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.; Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada., Mequanint S; Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada., Reichert SM; Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada., Belle Brown J; Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada., Black JE; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada., Ryan BL; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.; Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Jazyk: angličtina
Zdroj: BMJ open diabetes research & care [BMJ Open Diabetes Res Care] 2018 Apr 24; Vol. 6 (1), pp. e000503. Date of Electronic Publication: 2018 Apr 24 (Print Publication: 2018).
DOI: 10.1136/bmjdrc-2017-000503
Abstrakt: Objective: Very few real-world studies have been conducted to assess the incidence of diabetes-related hypoglycemia. Moreover, there is a paucity of studies that have investigated hypoglycemia among people taking secretagogues as a monotherapy or in combination with insulin. Accordingly, our research team developed and validated the InHypo-DM Person with Diabetes Mellitus Questionnaire (InHypo-DMPQ) with the aim of capturing the real-world incidence of self-reported, symptomatic hypoglycemia. The questionnaire was administered online to a national sample of Canadians (≥18 years old) with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) treated with insulin and/or insulin secretagogues.
Research Design and Methods: Self-report data obtained from the InHypo-DMPQ were descriptively analyzed to ascertain the crude incidence proportions and annualized incidence densities (rates) of 30-day retrospective non-severe and 1-year retrospective severe hypoglycemia, including daytime and nocturnal events.
Results: A total of 552 people (T2DM: 83%; T1DM: 17%) completed the questionnaire. Over half (65.2%) of the total respondents reported experiencing at least one event (non-severe or severe) at an annualized crude incidence density of 35.1 events per person-year. The incidence proportion and rate of non-severe events were higher among people with T1DM versus T2DM (77% and 55.7 events per person-year vs 54% and 28.0 events per person-year). Severe hypoglycemia was reported by 41.8% of all respondents, at an average rate of 2.5 events per person-year.
Conclusions: The results of the InHypo-DMPQ, the largest real-world investigation of hypoglycemia epidemiology in Canada, suggest that the incidence of hypoglycemia among adults with diabetes taking insulin and/or insulin secretagogues is higher than previously thought.
Competing Interests: Competing interests: SBH: Sanofi: grant, personal fees, member advisory board, consultant; Eli Lilly: grant, personal fees, member advisory board, consultant, clinical studies; Novo Nordisk: grant, personal fees, member advisory board, consultant, clinical studies; Janssen: grant, personal fees, member advisory board, consultant; Merck: personal Fees, member advisory board, consultant; AstraZeneca: grant, personal fees, member advisory board, consultant, clinical studies; Abbott: grant, personal fees, member advisory board, consultant; Boehringer Ingelheim: grant, personal fees, member advisory board, consultant, clinical studies; JDRF: grant; Lawson: grant; Medtronic: personal fees, member advisory board; Amgen: personal fees, member advisory board; Health Canada/First Nations and Inuit Health Branch: grant. SMR: Sanofi: grant, coinvestigator for clinical trials (but with no direct monies for me), fees for presentations; AstraZeneca: grant, coinvestigator for clinical trials (but with no direct monies for me), fees for presentations; Novo Nordisk: grant, coinvestigator of clinical trials, with travel for meetings (but no direct grant monies for me), fees paid for presentations; Boehringer Ingelheim: grant, coinvestigator for clinical trials (but with no direct monies for me), fees for presentations; Servier: grant, coinvestigator of clinical trials, with travel for meetings (but no direct grant monies for me), fees paid for presentations; Janssen: fees paid for presentations; Eli Lilly: fees paid for presentations; Merck: fees paid for presentations; Abbott: fees paid for presentations.
Databáze: MEDLINE