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Impact of hypoglycemia on patients with type 2 diabetes mellitus and their quality of life, work productivity, and medication adherence

Authors Lopez JMS, Annunziata K, Bailey RA, Rupnow MFT, Morisky DE

Received 6 December 2013

Accepted for publication 25 January 2014

Published 8 May 2014 Volume 2014:8 Pages 683—692

DOI https://doi.org/10.2147/PPA.S58813

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Janice MS Lopez,1 Kathy Annunziata,2 Robert A Bailey,1 Marcia FT Rupnow,1 Donald E Morisky3

1Janssen Scientific Affairs, LLC, Raritan, NJ, 2Kantar Health, Princeton, NJ, 3University of California at Los Angeles Fielding School of Public Health, Los Angeles, CA, USA

Background: The purpose of this study was to determine the characteristics of adults with type 2 diabetes mellitus (T2DM) that correlate with greater risk of hypoglycemia and determine the impact of hypoglycemia on health-related quality of life, work productivity, and medication adherence from a patient perspective.
Methods: Data from a large web-based survey were retrospectively analyzed. Adults with a diagnosis of T2DM taking antihyperglycemic agents were included in the analysis. Participants with knowledge of their hypoglycemic history were divided into three groups: those experiencing recent hypoglycemia (previous 3 months), those experiencing nonrecent hypoglycemia, and those never experiencing hypoglycemia.
Results: Of the participants with T2DM taking antihyperglycemic agents who were knowledgeable of their hypoglycemia history, 55.7% had ever experienced hypoglycemia. Of those, 52.7% had recent hypoglycemia. Compared with those who never experienced hypoglycemia, those who experienced hypoglycemia tended to: be younger; be more aware of their glycated hemoglobin (HbA1c) levels; have higher HbA1c levels; have a higher body mass index; have higher Charlson Comorbidity Index scores; be on insulin, sulfonylureas, and/or glucagon-like peptide-1 agonists; and be less adherent to their antihyperglycemic agents. Hypoglycemia interfered with social activities, caused more missed work (absenteeism), more impairment while at work (presenteeism), and decreased overall work productivity compared with patients who had never experienced hypoglycemia. Overall health-related quality of life, as determined by the Short Form-36 health questionnaire, was negatively impacted by hypoglycemia. Both Physical and Mental Summary scores were significantly lower for the recent hypoglycemia and nonrecent hypoglycemia groups compared with the never hypoglycemia group.
Conclusion: Hypoglycemia can negatively impact many aspects of life. Greater awareness of those who are at risk for developing hypoglycemia can lead to the development of measures (eg, patient and physician education) to prevent future hypoglycemia episodes.

Keywords: adherence, survey, patient preference, burden, antihyperglycemic, low glucose effect, hemoglobin A1c

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