Medical Resource Use, Disturbance of Daily Life and Burden of Hypoglycemia in Insulin-treated Patients With Diabetes

Results From a European Online Survey

William D Willis; Jesús I Diago-Cabezudo; Anne Madec-Hily; Aftab Aslam


Expert Rev Pharmacoeconomics Outcomes Res. 2013;13(1):123-130. 

In This Article

Expert Commentary

Hypoglycemia and fear of hypoglycemia are common in patients with diabetes, and if patients experience a SHE, fear of future hypoglycemic events is increased. In the present survey, approximately 40% of patients admitted that fear of hypoglycemia caused them to maintain their blood glucose levels at higher than recommended values. Accurate quantification is now needed of the degree to which maintaining high blood glucose increases HbA1c levels, the risks of short and long-term diabetic complications, and the overall financial burden of diabetes to healthcare systems.

Clearly, the current survey shows that there is a considerable incidence of hypoglycemic events among individuals with insulin-treated diabetes. Furthermore, the incidence of hypoglycemic events is associated with a substantial loss of work-related productivity and significant overall costs to healthcare systems due to consultations with healthcare practitioners, hospital admissions and emergency room visits.

SMBG is a widely recognized tool that is needed to improve glycemic control in patients with insulin-treated diabetes.[32] Such monitoring markedly reduces the risks of, and prevents, 'asymptomatic' hypoglycemia.[33] Thus, the ADA recommends that patients with diabetes who are using multiple daily insulin injections should perform SMBG ≥ three-times daily; the ADA also considers SMBG, including that after meals, as relevant for helping to attain glycemic targets in patients with diabetes who are using irregular insulin therapy, in patients receiving oral antidiabetic therapy and in those treated with dietary therapy alone.[34] Importantly, SMBG, using novel BGMs that provide warnings of hypoglycemia, appears particularly appealing to insulin-treated patients with diabetes, since it could provide patients with confidence and reassurance in avoiding hypoglycemia, reduce fear of hypoglycemia and allow patients to maintain lower blood glucose levels without an increased incidence of hypoglycemic events. Clearly, the widespread use of such BGMs could have the potential to markedly reduce the emotional and economic burden of diabetes.