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Hypoglycaemia in patients with type 2 diabetes treated with a combination of metformin and sulphonylurea therapy in France
Author(s) -
Vexiau P.,
Mavros P.,
Krishnarajah G.,
Lyu R.,
Yin D.
Publication year - 2008
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/j.1463-1326.2008.00883.x
Subject(s) - worry , metformin , medicine , type 2 diabetes , quality of life (healthcare) , diabetes mellitus , observational study , hypoglycemia , insulin , cross sectional study , pediatrics , endocrinology , psychiatry , anxiety , nursing , pathology
Context: Hypoglycaemia from antihyperglycaemic drugs may have a significant impact on patients’ health‐related quality of life. Combination use of metformin and a sulphonylurea has become increasingly common; yet, the impact of hypoglycaemia on quality of life in these patients is not well documented. Objective: To examine patient‐reported experience of hypoglycaemia, worry about hypoglycaemic symptoms and the impact of hypoglycaemia on patients’ quality of life associated with use of sulphonylurea co‐administered with metformin. Design: This was an observational, cross‐sectional, multi‐centre study. Setting: A total of 98 primary care centres in France during October to December 2005. Patients: A total of 400 patients with type 2 diabetes, who were ≥35 years old and who had been treated with metformin and a sulphonylurea for at least 6 months, completed questionnaires during their usual primary care office visit. Main Outcome Measures: Frequency and severity of hypoglycaemic symptoms in the past 6 months, the Worry subscale of the Hypoglycaemic Fear Survey‐II (HFS‐II) and the EuroQol‐5 Dimensions (EQ‐5D) questionnaire. Results: A total of 136 (34%) patients reported experiencing hypoglycaemia, of whom 78 (58%) experienced mild, 40 (30%) experienced moderate and 16 (12%) experienced severe or very severe symptoms. Mean score on the HFS‐II Worry scale was higher for patients who reported having hypoglycaemia than for those who did not (19.0 vs. 10.2; p < 0.0001) and increased with severity of hypoglycaemic symptoms. In linear regression analyses, more severe symptoms of hypoglycaemia were significantly associated with higher scores on the HFS‐II Worry scale (p = 0.0162) among patients with hypoglycaemic symptoms. Summary scores on the EQ‐5D were lower for patients who reported hypoglycaemia than for those who did not (p = 0.0001) and, in multivariate analysis, the experience of hypoglycaemia was negatively associated with the EQ‐5D summary score (p < 0.0001). Conclusion: The occurrence and severity of hypoglycaemic symptoms were associated with increased patient worry about hypoglycaemia and lower health‐related quality of life among type 2 diabetic patients being treated with both metformin and a sulphonylurea.