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

IF 8.4 1区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetologia Pub Date : 2024-10-01 Epub Date: 2024-07-30 DOI:10.1007/s00125-024-06233-1

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

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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.

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低血糖对成年糖尿病患者日常功能的影响：使用 Hypo-METRICS 应用程序进行的前瞻性观察研究。

目的/假设：这项工作旨在利用新颖的 Hypo-METRICS 应用程序，研究低血糖对 1 型糖尿病或接受胰岛素治疗的 2 型糖尿病成人患者日常功能的影响：连续 70 天，594 名成人（1 型糖尿病患者，人数=274；2 型糖尿病患者，人数=320）完成了简短的早晚 Hypo-METRICS "签到"，了解他们经历的低血糖和日常功能。参与者在研究期间佩戴盲法血糖传感器（即参与者无法获得数据）。使用多层次回归模型比较了有无个人报告的低血糖（PRH）和/或传感器检测到的低血糖（SDH）的日夜：参试者平均（± SD）86.3±12.5%在早晨签到，90.8±10.7%在傍晚签到。对于两种类型的糖尿病患者，SDH本身与日常功能评分的变化无明显关联。然而，日间和夜间 PRH（无论有无 SDH）与当天晚些时候或睡眠时的能量水平、情绪、认知功能、负面情绪和对低血糖的恐惧的恶化有明显关系。此外，夜间 PRH（无论是否伴有 SDH）与睡眠质量（1 型和 2 型糖尿病）和记忆力（2 型糖尿病）的恶化有显著相关性。此外，日间 PRH（无论有无 SDH）与睡眠时对高血糖的恐惧（1 型糖尿病）、记忆力（1 型和 2 型糖尿病）和社会功能（2 型糖尿病）的恶化有关：这项前瞻性真实世界研究显示，PRH 对多个日常功能领域产生了影响，而单纯 SDH 则没有。这些数据表明，所观察到的负面影响主要来自于对低血糖（即 PRH）的主观意识，即通过症状或传感器警报/读数和/或采取行动预防或治疗低血糖发作的需要。

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来源期刊

Diabetologia 医学-内分泌学与代谢

CiteScore

18.10

自引率

2.40%

发文量

193

审稿时长

1 months

期刊介绍： Diabetologia, the authoritative journal dedicated to diabetes research, holds high visibility through society membership, libraries, and social media. As the official journal of the European Association for the Study of Diabetes, it is ranked in the top quartile of the 2019 JCR Impact Factors in the Endocrinology & Metabolism category. The journal boasts dedicated and expert editorial teams committed to supporting authors throughout the peer review process.