Effects of continuous glucose monitor-recorded nocturnal hypoglycaemia on quality of life and mood during daily life in type 1 diabetes
- 14 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Diabetologia
- Vol. 64 (4), 903-913
- https://doi.org/10.1007/s00125-020-05360-9
Abstract
Aims/hypothesis The aim of this work was to assess the effect of spontaneous nocturnal hypoglycaemia on quality of life and mood during subsequent days in type 1 diabetes. Methods A total of 153 people with type 1 diabetes participated in 6 days of blinded continuous glucose monitoring while documenting hypoglycaemic symptoms, quality of life and mood, daily. Hypoglycaemia was defined by interstitial glucose ≤3.9 mmol/l (IG3.9) and ≤ 3.0 mmol/l (IG3.0) for ≥15 min and was classified as asymptomatic if no hypoglycaemic symptoms were reported. Results Self-estimated quality of life assessed by the EQ-5D VAS (but not by the WHO Well-Being Index) was higher the day after asymptomatic (but not after symptomatic) hypoglycaemic nights, as compared with non-hypoglycaemic nights (IG3.9, p = 0.021; IG3.0, p = 0.048). The effect increased with lower glucose nadir and longer duration of nocturnal hypoglycaemia (IG3.9, p = 0.03). The finding was confined to participants with impaired hypoglycaemia awareness. There was no effect of nocturnal hypoglycaemia on mood or self-estimated effectiveness at work the following day. Conclusions/interpretation Individuals with type 1 diabetes and impaired hypoglycaemia awareness reported higher quality of life on days preceded by nights with asymptomatic (but not symptomatic) hypoglycaemia. The effect was amplified by lower glucose nadir and longer duration of the episodes and may help explain resistance to implementation of interventions to reduce hypoglycaemia in many people with impaired hypoglycaemia awareness. Graphical abstractFunding Information
- The Danish Medical Research Grant
- The Jascha Foundation
- The Toyota Foundation, Denmark
- Nordsjællands Hospital
This publication has 44 references indexed in Scilit:
- Health-related quality of life associated with daytime and nocturnal hypoglycaemic events: a time trade-off survey in five countriesHealth and Quality of Life Outcomes, 2013
- Hypoglycemia Unawareness Is Associated With Reduced Adherence to Therapeutic Decisions in Patients With Type 1 DiabetesDiabetes Care, 2009
- Attenuation of Counterregulatory Responses to Recurrent Hypoglycemia by Active Thalamic InhibitionDiabetes, 2008
- Utility values for symptomatic non-severe hypoglycaemia elicited from persons with and without diabetes in Canada and the United KingdomHealth and Quality of Life Outcomes, 2008
- Attenuation of Amydgala and Frontal Cortical Responses to Low Blood Glucose Concentration in Asymptomatic Hypoglycemia in Type 1 DiabetesDiabetes, 2007
- Differential changes in brain glucose metabolism during hypoglycaemia accompany loss of hypoglycaemia awareness in men with type 1 diabetes mellitus. An [11C]-3-O-methyl-d-glucose PET studyDiabetologia, 2005
- Reduced Awareness of Hypoglycemia in Adults With IDDM: A prospective study of hypoglycemic frequency and associated symptomsDiabetes Care, 1995
- Changes in mood during acute hypoglycemia in healthy participants.Journal of Personality and Social Psychology, 1995
- Frequency of Severe Hypoglycemia in Patients With Type I Diabetes With Impaired Awareness of HypoglycemiaDiabetes Care, 1994
- EuroQol - a new facility for the measurement of health-related quality of lifeHealth Policy, 1990