179-OR: Assessing the Impact of Hypoglycemia among People with Diabetes in the U.S. and EU

Hypoglycemia, where blood glucose falls below 70 mg/dL, can be an unfortunately common and serious burden for people with diabetes (PWDs) on insulin. Despite this, its prevalence in the daily lives of PWDs is understudied among specific therapy types. This research aimed to comparatively assess patient experiences with hypoglycemia in the US and Europe (EU). From August-October 2023, insulin-using PWD in the US (n=3,355) and EU (n=2,480) took an online survey assessing the impact of hypoglycemia in their lives. Respondents reported how frequently they experience mild (55-70 mg/dL) and moderate (40-54 mg/dL) hypoglycemia. In the study’s analysis, highly impacted individuals were operationalized as PWD experiencing near-daily milds and occasional (weekly) moderates. Hypoglycemia impact was compared across region by type of diabetes and insulin therapy regimen (T1 adults on a pump, T1 adults on multiple daily injections (MDI), T1 kids (<18 years), T2 adults on MDI, and T2 adults on basal insulin only). The prevalence of highly impacted PWD is significantly higher in EU than in the US for all patient segments except PWD on MDI. Compared to in EU, high hypoglycemia impact rates in the US are significantly lower among T1 adults on a pump (15% vs. 21%, p<.001), T1 kids (21% vs. 33%, p<.01), T2 adults on basal insulin only (2% vs. 6%, p<.05). There are no significant differences in the prevalence of high hypoglycemia impact among T1 adults on MDI in the US (20%) and EU (22%), nor among T2 adults on MDI in the US (3%) and EU (4%). It is notable that all patient segments except those on MDI are more impacted by hypoglycemia in EU than in the US, especially given the differences in US and EU health systems. Further research should aim to uncover the origin of this disparity, why it specifically affects pump users and not MDI users, and assess whether it also translates into clinical outcomes and daily lived experiences of PWDs.