Journal Article

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

Evans, Mark, Heller, Simon, McCrimmon, Rory J., Hendrieckx, Christel, Speight, Jane, Zaremba, Natalie, Vaag, Allan, Mahmoudi, Zeinab, Brøsen, Julie Maria Bøggild, Amiel, Stephanie A., Abbink, Evertine, Baumann, Petra Martina, Broadley, Melanie, Martine-Edith, Gilberte, Mader, Julia K., Choudhary, Pratik, Pouwer, Frans, de Galan, Bastiaan, Divilly, Patrick, Cigler, Monika, Pedersen-Bjergaard, Ulrik, Søholm, Uffe, Renard, Eric

2024

Overview

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

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V,Springer Verlag
• Subject: Activities of Daily Living / Adult / Adults / Aged / Blood Glucose - metabolism / Blood Glucose Self-Monitoring / Clinical Medicine / Daytime / Diabetes / Diabetes mellitus (insulin dependent) / Diabetes mellitus (non-insulin dependent) / Diabetes Mellitus, Type 1 - complications / Diabetes Mellitus, Type 1 - physiopathology / Diabetes Mellitus, Type 1 - psychology / Diabetes Mellitus, Type 2 - complications / Diabetes Mellitus, Type 2 - physiopathology / Emotions / Endocrinology and Diabetes / Endocrinology and metabolism / Endokrinologi och diabetes / Fear / Female / Human health and pathology / Human Physiology / Humans / Hyperglycemia / Hypoglycemia / Hypoglycemia - physiopathology / Hypoglycemia - psychology / Hypoglycemic Agents - therapeutic use / Insulin - therapeutic use / Internal Medicine / Klinisk medicin / Life Sciences / Male / Medical and Health Sciences / Medicin och hälsovetenskap / Medicine / Medicine & Public Health / Memory / Metabolic Diseases / Middle Aged / Mobile Applications / Nighttime / Observational studies / Prospective Studies / Quality of life / Regression analysis / Santé publique et épidémiologie / Sensors / Tissues and Organs