The impact of hypoglycemia on quality of life in type 2 diabetes : a systematic review.
Barendse, Shalleen, Singh, Harsimran, Frier, Brian M. and Speight, Jane 2010, The impact of hypoglycemia on quality of life in type 2 diabetes : a systematic review., in ADA 70th Scientific Sessions 2010, American Diabetes Association, Alexandria, Va..
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The impact of hypoglycemia on quality of life in type 2 diabetes : a systematic review.
Hypoglycemia is the commonest and most serious side-effect of insulin treatment for Type 1 diabetes (T1DM). The prevalence of hypoglycemia is lower in insulin-treated Type 2 diabetes (T2DM) than in T1DM but the prevalence increases with duration of insulin therapy and increasingly resembles T1DM. As hypoglycemia has not been widely recognised to affect people with T2DM, its impact on quality of life (QoL) has received little attention.
A systematic literature review was performed to identify empirical papers published in English since 1966 reporting the effect of hypoglycemia on any patient-reported outcomes (PROs), including QoL, in T2DM. Despite our specific interest in QoL, the inclusion criteria were defined broadly to encompass a range of self-assessed psychosocial outcomes, including generic and diabetes-specific QoL, emotional well-being and health utilities. Studies were excluded in which the impact of hypoglycemia was confounded by treatment effects. Our search included: MEDLINE, PsycINFO, CINAHL. Abstracts were screened independently by two investigators.
Of 2,469 abstracts, Thirty-one met the inclusion criteria and were subjected to data extraction and analysis. These comprised four controlled trials and twenty-seven others (including cross-sectional and health utility studies). The results indicate associations between the experience of hypoglycemia and a range of adverse PROs, including impaired QoL and well-being, higher levels of anxiety, depression and anger and loss of health utility. Fear of hypoglycemia was also associated with compensatory lifestyle limitations and changes.
Publications suggest that QoL and other psychosocial outcomes are impaired by the experience and/or fear of hypoglycemia in T2DM, however, very few studies have directly investigated this phenomenon to date. Interpretation of the evidence is hampered by inconsistent or inadequate definitions and measurement of both hypoglycemia and QoL outcomes, by confounding of the impact of hypoglycemia and by treatment factors. Targeted research using appropriate study design is needed to quantify and qualify the true impact of hypoglycemia on QoL in people with T2DM.
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eng
Field of Research
119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective
970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category
E2.1 Full written paper - non-refereed / Abstract reviewed
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