Severe hypoglycaemia linked to tighter glucose control, higher worry scores

Among older Southeast Asian type 2 diabetes mellitus (T2DM) patients, severe hypoglycaemia tends to occur with tighter glycaemic control, greater impaired hypoglycaemia awareness (IAH), and higher worry scores, regardless of treatment regimens, according to a study.

The study included 92 insulin-treated Southeast Asian T2DM patients aged >65 years old with glycated haemoglobin (Hba1c) <8 percent. All of them completed questionnaires that assessed their experience of hypoglycaemia and the presence of IAH. Information on insulin treatment regimens, Hba1c, and comorbidities were also collected.

About 15 percent of the population experienced at least one episode of severe hypoglycaemia over the past year. Compared with those who had no such episode, patients who had severe hypoglycaemia had lower Hba1c, higher Gold score (mean, 3.9 vs 2.5; p<0.05), and higher Hypoglycemia Fear Survey (HFS) worry score (mean, 39.1 vs 31.8; p<0.05).

There were no significant between-group differences in duration of diabetes and insulin treatment, treatment regimens, and diabetes-associated comorbidities except peripheral vascular disease.

Moreover, HFS behaviour score, hypoglycaemia risk modifying behaviour, and social economic status were similar in patients who had vs had no severe hypoglycaemia.

In light of the findings, researchers underscored the importance of the clinicians’ role in tightening glycaemic control and influencing the risk of severe hypoglycaemia. They believed that a standard structured diabetes education could help reduce the risk of severe hypoglycaemia in the present population.