Hypoglycaemia in patients with type 2 diabetes treated with a combination of metformin and sulphonylurea therapy in France
- 23 April 2008
- journal article
- research article
- Published by Wiley in Diabetes, Obesity and Metabolism
- Vol. 10 (s1), 16-24
- https://doi.org/10.1111/j.1463-1326.2008.00883.x
Abstract
Hypoglycaemia from antihyperglycaemic drugs may have a significant impact on patients' health-related quality of life. Combination use of metformin and a sulphonylurea has become increasingly common; yet, the impact of hypoglycaemia on quality of life in these patients is not well documented. To examine patient-reported experience of hypoglycaemia, worry about hypoglycaemic symptoms and the impact of hypoglycaemia on patients' quality of life associated with use of sulphonylurea co-administered with metformin. This was an observational, cross-sectional, multi-centre study. A total of 98 primary care centres in France during October to December 2005. A total of 400 patients with type 2 diabetes, who were > or = 35 years old and who had been treated with metformin and a sulphonylurea for at least 6 months, completed questionnaires during their usual primary care office visit. Frequency and severity of hypoglycaemic symptoms in the past 6 months, the Worry subscale of the Hypoglycaemic Fear Survey-II (HFS-II) and the EuroQol-5 Dimensions (EQ-5D) questionnaire. A total of 136 (34%) patients reported experiencing hypoglycaemia, of whom 78 (58%) experienced mild, 40 (30%) experienced moderate and 16 (12%) experienced severe or very severe symptoms. Mean score on the HFS-II Worry scale was higher for patients who reported having hypoglycaemia than for those who did not (19.0 vs. 10.2; p < 0.0001) and increased with severity of hypoglycaemic symptoms. In linear regression analyses, more severe symptoms of hypoglycaemia were significantly associated with higher scores on the HFS-II Worry scale (p = 0.0162) among patients with hypoglycaemic symptoms. Summary scores on the EQ-5D were lower for patients who reported hypoglycaemia than for those who did not (p = 0.0001) and, in multivariate analysis, the experience of hypoglycaemia was negatively associated with the EQ-5D summary score (p < 0.0001). The occurrence and severity of hypoglycaemic symptoms were associated with increased patient worry about hypoglycaemia and lower health-related quality of life among type 2 diabetic patients being treated with both metformin and a sulphonylurea.Keywords
This publication has 27 references indexed in Scilit:
- The relationship between body mass index and health-related quality of life: comparing the EQ-5D, EuroQol VAS and SF-6DInternational Journal of Obesity, 2006
- The economic and quality of life impact of hypoglycemiaThe European Journal of Health Economics, 2005
- Hypoglycemia in stable, insulin-treated veterans with type 2 diabetesA prospective study of 1662 episodesJournal of Diabetes and its Complications, 2005
- EQ-SD: a measure of health status from the EuroQol GroupAnnals of Medicine, 2001
- Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)The Lancet, 1998
- Test-retest reliability of health state valuations collected with the EuroQol questionnaireSocial Science & Medicine, 1994
- Frequency of severe hypoglycemia in insulin-dependent diabetes mellitus can be predicted from self-monitoring blood glucose dataJournal of Clinical Endocrinology & Metabolism, 1994
- Testing the validity of the Euroqol and comparing it with the SF-36 health survey questionnaireQuality of Life Research, 1993
- Correlates of hypoglycemic fear in Type I and Type II diabetes mellitus.Health Psychology, 1992
- EuroQol - a new facility for the measurement of health-related quality of lifeHealth Policy, 1990