Hypoglycemia Common Among Type 2 Diabetes Patients Treated with Insulin

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According to the GAPP2™ (Global Attitudes of Patients and Physicians) survey, funded by Novo Nordisk and presented today at the Annual Meeting of the European Association for the Study of Diabetes (EASD), four out of five (80%) people with type 2 diabetes have experienced self-treated hypoglycemia, with 36% experiencing an episode in the last month. These hypoglycemic episodes also affected the way that patients with type 2 diabetes managed their condition.

Nearly half (46%) of the patients in the study reported increasing blood glucose monitoring as a result of their last episode and more than one in 10 altered their long-acting insulin regime. In addition, according to the GAPP2™ survey, 16% of people with type 2 diabetes said they had intentionally not taken their insulin as prescribed and 14% had intentionally kept their blood sugar at a higher than recommended level in order to avoid hypoglycemia during the night.

Healthcare professionals also said that their prescribing decisions were influenced by the risk of self-treated hypoglycaemia. When deciding the type of insulin to prescribe, 82% took the risk of hypoglycemia into account and more than half (57%) started patients on a lower dose of long-acting insulin than recommended.

“Self-treated hypoglycemia represents a significant clinical challenge in type 2 diabetes, influencing both patient and prescriber behaviours in insulin management,” said lead researcher and health psychologist Dr. Meryl Brod of The Brod Group, Mill Valley, USA. “Less than optimal patient responses to self-treated hypoglycemia and non-adherent behavior need to be addressed to improve glycemic control and patient welfare.”

Insulin non-adherence can negatively impact blood sugar control and is an independent predictor of mortality. Furthermore, new data from the GAPP2™ survey confirmed that regardless of hypoglycemia, dosing irregularities of long-acting insulin remain common. However, while patients recognized the clinical consequences of this behaviour, a substantial proportion still intentionally did not take their insulin as prescribed. 

  • 77% of patients who had reduced a basal insulin dose admitted that on the last occasion they had done so deliberately
  • 63% of patients believed missing doses of basal insulin would have a negative impact on their long-term health
  • 37% said they would feel guilty if they missed a long-acting insulin dose
  • 48% of patients said they had missed a dose of basal insulin altogether
  • 51% said they had mistimed a basal dose by more than two hours
  • 38% said they had reduced a dose of basal insulin

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