Self-Reported Hypoglycemia in Insulin-Treated Patients with Diabetes: Results from the Philippines Cohort of the International Operations Hypoglycemia Assessment Tool (IO HAT) Study

Authors

Keywords:

International Operations Hypoglycemia Assessment Tool, insulin-treated patients with diabetes, hypoglycemia, Philippines

Abstract

*Visual Abstracts prepared by Dr. Monica Therese Cating-Cabral

Objective. To determine the frequency of hypoglycemia in insulin-treated patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in the non-interventional International Operations Hypoglycemia Assessment Tool (IO HAT) study.

Methodology.This sub-analysis included Filipino patients with T1DM or T2DM, aged 18 years and older, treated with insulin for more than 12 months, who completed the two-part self-assessment questionnaires (SAQ1 and SAQ2) and patient diaries that recorded hypoglycemia during retrospective (6 months/4 weeks before baseline) and prospective period (4 weeks after baseline) (ClinicalTrials.gov number: NCT02306681).

Results. A total of 671 patients were enrolled and completed the SAQ1 (62 patients with T1DM and 609 patients with T2DM). Almost all patients (100% in T1DM and 99.3% in T2DM) experienced at least 1 hypoglycemic event prospectively. The incidence of any hypoglycemia was also high in the prospective period compared to retrospective period (72.6 [95% CI: 64.8, 80.9] events PPY and 43.6 [95% CI: 37.8, 49.9] events PPY; p=0.001, respectively) in T1DM patients.

Conclusion. Among insulin-treated patients, higher rates of hypoglycemia were reported prospectively than retrospectively. This indicates that the patients in real-life setting often under report hypoglycemia. Patient education can help in accurate reporting and appropriate management of hypoglycemia and diabetes.

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Author Biographies

Roberto Mirasol, St. Luke's Medical Center, Quezon City Manila Doctors Hospital

Section Chief, Section of Endocrinology Diabetes and Metabolism, St Luke's Medical Center, Quezon City

Nemencio Nicodemus Jr., University of the Philippines Manila

Professor, Department of Biochemistry

Clinical Associate Professor, Department of Medicine

Anand Jain, Novo Nordisk Healthcare AG, Zurich

Senior Medical Manager

Arvind Vilas Gadekar, Novo Nordisk Pharma Operations (BAOS) Sdn. Bhd., Kuala Lumpur

Regional Medical Advisor

Susan Yu-Gan, Metropolitan Medical Center, Manila

Consultant in Endocrinology

References

Ramachandran A, Chamukuttan S, Shetty AS, Nanditha A. Trends in prevalence of diabetes in Asian countries. World J Diabetes. 2012;3(6):110-7. PMCID: PMC3382707. https://doi.org/10.4239/wjd.v3.i6.110.

IDF Western Pacific members: The Philippines. https://www.idf.org/our-network/regions-members/western-pacific/members/116-the-philippines.html. Accessed May 9, 2017.

Soria ML, Sy RG, Vega BS, et al. The incidence of type 2 diabetes mellitus in the Philippines: A 9-year cohort study. Diabetes Res Clin Pract. 2009;86(2):130-3.

PMID: 19766344. https://doi.org/10.1016/j.diabres.2009.07.014.

Tan GH. Diabetes care in the Philippines. Ann Glob Health. 2015;81(6):863-9. PMID: 27108153. https://doi.org/10.1016/j.aogh.2015.10.004.

Barrera JR, Jimeno CA, Paz-Pacheco E. Insulin resistance among adults with type 1 diabetes mellitus at the Philippine General Hospital. J Diabetes Metab. 2013;4(10):315. https://doi.org/10.4172/2155-6156.1000315.

You WP, Henneberg M. Type 1 diabetes prevalence increasing globally and regionally: The role of natural selection and life expectancy at birth. BMJ Open Diabetes Res Care. 2016;4(1):e000161. PMID: 26977306. PMCID: PMC4780042. https://doi.org/10.1136/bmjdrc-2015-000161.

Unite for Diabetes Philippines. Philippine practice guidelines on the diagnosis and management of diabetes. http://endo-society.org.ph/v5/wp-content/uploads/2013/06/Diabetes-United-for-Diabetes-Phil.pdf. Accessed May 9, 2017.

Funnel MM. The Diabetes Attitudes, Wishes, and Needs (DAWN) Study. Clin Diabetes. 2006;24(4):154-5. https://doi.org/10.2337/diaclin.24.4.154.

UK Hypoglycemia Study Group. Risk of hypoglycemia in types 1 and 2 diabetes: Effects of treatment modalities and their duration. Diabetologia. 2007;50(6):1140-7. PMID: 17415551. https://doi.org/10.1007/s00125-007-0599-y.

Fidler C, Elmelund Christensen T, Gillard S. Hypoglycemia: An overview of fear of hypoglycemia, quality-of-life, and impact on costs. J Med Econ. 2011;14(5):645-55. PMID: 21854191. https://doi.org/10.3111/13696998.2011.610852.

Khunti K, Alsifri S, Aronson R, et al. Rates and predictors of hypoglycaemia in 27 585 people from 24 countries with insulin-treated type 1 and type 2 diabetes: The global HAT study. Diabetes Obes Metab. 2016;18(9):907-15. PMID: 27161418. PMCID: PMC5031206. https://doi.org/10.1111/dom.12689.

Emral R, Pathan F, Cortes C, et al. Self-reported hypoglycemia in insulin-treated patients with diabetes: Results from an international survey of 7289 patients from nine countries. Diabetes Res Clin Pract. 2017;134:17-28. PMID: 28951336. https://doi.org/10.1016/j.diabres.2017.07.031.

ISPE. Guidelines for good pharmacoepidemiology practices (GPP). Pharmacoepidemiol Drug Saf. 2008;17(2):200-8. PMID: 17868186. https://doi.org/10.1002/pds.1471.

World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-4. PMID: 24141714. https://doi.org/10.1001/jama.2013.281053.

Workgroup on Hypoglycemia, American Diabetes Association. Defining and reporting hypoglycemia in diabetes: A report from the American Diabetes Association Workgroup on Hypoglycemia. Diabetes Care. 2005;28(5):1245-9. PMID: 15855602.

Donnelly LA, Morris AD, Frier BM, et al. Frequency and predictors of hypoglycaemia in type 1 and insulin-treated type 2 diabetes: A population-based study. Diabet Med. 2005;22(6):749-55. PMID: 15910627. https://doi.org/10.1111/j.1464-5491.2005.01501.x.

Lüddeke HJ, Sreenan S, Aczel S, et al. PREDICTIVE- a global, prospective observational study to evaluate insulin detemir treatment in types 1 and 2 diabetes: Baseline characteristics and predictors of hypoglycaemia from the European cohort. Diabetes Obes Metab. 2007;9(3):428-34. PMID: 17391171. https://doi.org/10.1111/j.1463-1326.2006.00677.x.

ADVANCE Collaborative Group, Patel A, MacMahon S, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358(24):2560-72. PMID: 18539916. https://doi.org/10.1056/NEJMoa0802987.

Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC, Miller ME, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;358(24):2545-59. PMID: 18539917. PMCID: PMC4551392. https://doi.org/ 10.1056/NEJMoa0802743.

Duckworth W, Abraira C, Moritz T, et al. Glucose control and vascular complications in veterans with type 2 diabetes. N Engl J Med. 2009;360(2):129-39. PMID: 19092145. https://doi.org/10.1056/NEJMoa0808431.

Aronson R, Goldenberg R, Boras D, Skovgaard R, Bajaj H. The Canadian hypoglycemia assessment tool program: Insights into rates and implications of hypoglycemia from an observational study. Can J Diabetes. 2018; 42(1):11-7. PMID: 28528246. https://doi.org/10.1016/j.jcjd.2017.01.007.

Jimeno CA, Sobrepeña LM, Mirasol RC. DiabCare 2008: Survey on glycemic control and the status of diabetes care and complications among patients with type 2 diabetes mellitus in the Philippines. Philipp J Intern Med. 2012;50(1):15-22.

Goh SY, Hussein Z, Rudijanto A. Review of insulin -associated hypoglycemia and its impact on the management of diabetes in Southeast Asian countries. J Diabetes Investig. 2017;8(5):635-45. PMID: 28236664. PMCID: PMC5584309. https://doi.org/10.1111/jdi.12647.

Chiang JL, Kirkman MS, Laffel LMB, Peters AL, Type 1 Diabetes Sourcebook Authors.: Type 1 diabetes through the life span: A position statement of the American Diabetes Association. Diabetes Care. 2014;37(7):2034-54. PMID: 24935775. https://doi.org/10.2337/dc14-1140.

Kalra S, Mukherjee JJ, Venkataraman S, et al. Hypoglycemia: The neglected complication. Indian J Endocrinol Metab. 2013;17(5):819-34. PMID: 24083163. PMCID: PMC3784865. https://doi.org/10.4103/2230-8210.117219.

Malek R, Gonzalez-Galvez G, El Naggar N, Shah S, Prusty V, Litwak L. Safety and effectiveness of insulin detemir in different age-groups in the a1chieve study. Diabetes Ther. 2013;4(1):77-90. PMID: 23670204. PMCID: PMC3687092. https://doi.org/10.1007/s13300-013-0021-3.

Diabetes Control and Complications Trial Research Group, Nathan DM, Genuth S, et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329(14):977-86. PMID: 8366922. https://doi.org/10.1056/NEJM199309303291401.

Published

2018-03-08

How to Cite

Mirasol, R., Nicodemus Jr., N., Jain, A., Gadekar, A. V., & Yu-Gan, S. (2018). Self-Reported Hypoglycemia in Insulin-Treated Patients with Diabetes: Results from the Philippines Cohort of the International Operations Hypoglycemia Assessment Tool (IO HAT) Study. Journal of the ASEAN Federation of Endocrine Societies, 33(1), 12. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/429

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