Objective: Compare functionality of T1DM patients who do or do not experience hypos and compare across hypo severities and requirement for medical help.

Methods: Data were drawn from 2016 Adelphi Disease Specific Programme, a real-world, cross-sectional study in 5EU/U.S. Physicians completed forms for the next 2 T1DM patients capturing comorbidities, demographics, disease duration, hypo details. Patients self-reported work, activity impairment, lifestyle impact. Patients were grouped based on hypo experience by 1. ever experienced vs. never, 2. mild vs. severe, 3. never needed medical attention vs. needed. Propensity score matching on gender, BMI, disease duration facilitated comparison between matched groups. p-values generated using Abadie-Imbens standard errors, and standardized mean differences <10% in matching covariates were sought.

Results: Of 1662 patients, 861 (51.8%) never experienced hypos, 637 (38.3%) experienced mild and 164 (9.9%) severe hypos. Only 46 (2.8%) experienced a hypo needing medical help. Patients with hypos were more likely ‘sometimes/greatly’ affected in feelings about the future and freedom to eat/drink (both p<=0.001), leisure activities (p<0.05) and self-confidence (p=0.056) vs. patients with no hypos. Severe hypo patients were more likely ‘sometimes/greatly’ affected when traveling (p=0.019) and were more likely to be anxious (p=0.007) or depressed (p=0.064) vs. mild hypo patients. While analysis of hypos needing medical attention was limited due to low bases, patients needing medical attention were more likely to have depression (p=0.003), anxiety (p=0.053) and increased work absenteeism (p<0.01).

Conclusion: While physicians report half of T1DM patients do not experience hypos, those who do are more impacted concerning lifestyle, confidence and outlook. More severe hypos translates to increased psychological manifestations. During the management of these patients, the broader implications of hypo experience should not be underestimated.

Disclosure

E.D. Sullivan: None. J. Kemp: None. J. Piercy: None. V. Higgins: None.

© 2019 by the American Diabetes Association.
2019
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