Impact of severe and symptomatic hypoglycemia on quality of life and fear of hypoglycemia in type 1 and type 2 diabetes. Results of the Hypos-1 observational study
Impact of severe and symptomatic hypoglycemia on quality of life and fear of hypoglycemia in type 1 and type 2 diabetes. Results of the Hypos-1 observational study
复制标题
DOI：
10.1016/j.numecd.2019.04.009
复制
发表时间：
2019-07-01
影响因子：
3.9
通讯作者：
Cucinotta, D.
中科院分区：
文献类型：
--
作者：
Rossi, Maria Chiara;Nicolucci, Antonio;Cucinotta, D.
背景和目的：低血糖是糖尿病患者的一个相关负担。评估低血糖/对低血糖的恐惧对 T1DM 和 T2DM 患者的生活质量 (QoL) 和行为的影响。方法和结果：HYPOS-1 是一项观察性回顾性研究。对低血糖恐惧症（低血糖恐惧问卷，FHQ）、一般健康状况（EuroQol 问卷视觉模拟量表，EQ5D-VAS）、心理健康（WHO-5 健康指数，WHO-5）、糖尿病相关困扰（糖尿病 5 问题领域，PAID-5）以及既往有或没有严重症状的人之间的低血糖后纠正/预防行为进行比较低血糖和 FHQ 评分的三分位数。进行多变量分析以确定与 FHQ 得分第三个三分位的可能性相关的因素。总共有 2229 名患者参与。严重低血糖对 T1DM 和 T2DM 中的 EQ5D-VAS、WHO-5、PAID-5 和 FHQ 具有统计学显着性和临床相关性（以效应大小衡量）的负面影响。在 T2DM 中，症状发作与严重低血糖具有相似的影响。从 FHQ 第一个三分位数到第三个三分位数，发现 EQ-5D VAS 和 WHO-5 得分较低，而 PAID-5 水平较高。第三个三分位数的患者更频繁地执行对代谢控制产生负面影响的纠正/预防措施。既往低血糖、胰岛素治疗、女性性别、年龄和学校教育是与第三个三分位数可能性增加相关的独立因素。结论：不仅严重低血糖而且有症状的低血糖都会对患者的生活质量产生负面影响，尤其是在 T2DM 中。解决对低血糖的恐惧应该是糖尿病教育的目标。 (C) 2019 意大利糖尿病学会、意大利动脉粥样硬化研究学会、意大利人类营养学会以及费德里科二世大学临床医学和外科系。由 Elsevier B.V. 出版。保留所有权利。
Background and aims: Hypoglycemia represents a relevant burden in people with diabetes. Consequences of hypoglycemia/fear of hypoglycemia on quality of life (QoL) and behaviors of patients with T1DM and T2DM were assessed.Methods and results: HYPOS-1 was an observational retrospective study. Fear of hypoglycemia (Fear of Hypoglycemia Questionnaire, FHQ), general health status (visual analog scale of EuroQol questionnaire, EQ5D-VAS) psychological well-being (WHO-5 well being index, WHO-5), diabetes related distress (Problem Areas in Diabetes 5, PAID-5), and corrective/preventive behaviors following hypoglycemia were compared between people with and without previous experience of severe and symptomatic hypoglycemia and by tertiles of FHQ scores. A multivariate analysis was performed to identify factors associated with the likelihood of being in the third tertile of FHQ score. Overall, 2229 patients were involved. Severe hypoglycemia had statistically significant and clinically relevant (measured as effect sizes) negative impact on EQ5D-VAS, WHO-5, PAID-5, and FHQ both in T1DM and T2DM. In T2DM, symptomatic episodes had similar impact of severe hypoglycemia. Moving from the first to the third FHQ tertile, lower scores of EQ-5D VAS and WHO-5, and higher levels of PAID-5 were found. Patients in the third tertile performed more frequently corrective/preventive actions that negatively impact on metabolic control. Previous hypoglycemia, insulin treatment, female gender, age, and school education were the independent factors associated with increased likelihood to be in the third tertile.Conclusion: Not only severe but also symptomatic hypoglycemia negatively affect patient QoL, especially in T2DM. Addressing fear of hypoglycemia should be a goal of diabetes education. (C) 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.