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Diabetologia
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The impact of hypoglycaemia on daily functioning among adults with diabetes: a prospective observational study using the Hypo-METRICS app

a prospective observational study using the Hypo-METRICS app
Authors: Søholm, Uffe; Broadley, Melanie; Zaremba, Natalie; Divilly, Patrick; Baumann, Petra Martina; Mahmoudi, Zeinab; Martine-Edith, Gilberte; +17 Authors

The impact of hypoglycaemia on daily functioning among adults with diabetes: a prospective observational study using the Hypo-METRICS app

Abstract

Abstract Aims/hypothesis The aim of this work was to examine the impact of hypoglycaemia on daily functioning among adults with type 1 diabetes or insulin-treated type 2 diabetes, using the novel Hypo-METRICS app. Methods For 70 consecutive days, 594 adults (type 1 diabetes, n=274; type 2 diabetes, n=320) completed brief morning and evening Hypo-METRICS ‘check-ins’ about their experienced hypoglycaemia and daily functioning. Participants wore a blinded glucose sensor (i.e. data unavailable to the participants) for the study duration. Days and nights with or without person-reported hypoglycaemia (PRH) and/or sensor-detected hypoglycaemia (SDH) were compared using multilevel regression models. Results Participants submitted a mean ± SD of 86.3±12.5% morning and 90.8±10.7% evening check-ins. For both types of diabetes, SDH alone had no significant associations with the changes in daily functioning scores. However, daytime and night-time PRH (with or without SDH) were significantly associated with worsening of energy levels, mood, cognitive functioning, negative affect and fear of hypoglycaemia later that day or while asleep. In addition, night-time PRH (with or without SDH) was significantly associated with worsening of sleep quality (type 1 and type 2 diabetes) and memory (type 2 diabetes). Further, daytime PRH (with or without SDH), was associated with worsening of fear of hyperglycaemia while asleep (type 1 diabetes), memory (type 1 and type 2 diabetes) and social functioning (type 2 diabetes). Conclusions/interpretation This prospective, real-world study reveals impact on several domains of daily functioning following PRH but not following SDH alone. These data suggest that the observed negative impact is mainly driven by subjective awareness of hypoglycaemia (i.e. PRH), through either symptoms or sensor alerts/readings and/or the need to take action to prevent or treat episodes. Graphical Abstract

Keywords

Male, Adult, Blood Glucose, Quality of life, Hypoglycemia/psychology, 610, Hypoglycemic Agents/therapeutic use, name=Internal Medicine, Article, /dk/atira/pure/subjectarea/asjc/2700/2724, 616, Activities of Daily Living, Diabetes Mellitus, Humans, Hypoglycemic Agents, Insulin, Internal Medicine - Radboud University Medical Center, Prospective Studies, Type 2/physiopathology, Ecological momentary assessment, Aged, Blood Glucose/metabolism, Blood Glucose Self-Monitoring, daily functioning, Type 1/physiopathology, Middle Aged, Mobile Applications, Hypoglycemia, Diabetes and Metabolism, Diabetes Mellitus, Type 1, quality of life, Diabetes Mellitus, Type 2, /dk/atira/pure/subjectarea/asjc/2700/2712, Insulin/therapeutic use, Female, Daily functioning, name=Endocrinology, Hypoglycaemia, hypoglycaemia

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
6
Top 10%
Average
Top 10%
Green
hybrid