Abstract
Background: Hypoglycemia is the most common and serious side effect of glucose-lowering medications and considered the rate-limiting side effect in achieving tight glycemic control in Diabetes Mellitus (DM). Diabetes-related hypoglycemia has both short-term and long-term complications. Moreover, hypoglycemia episodes, especially the severe ones, lead to a considerable increase in both direct and indirect medical care costs
Objectives: Primary objective: Study the knowledge about hypoglycemia among type 2 diabetic patients attending the diabetes centre clinics, F & CM Department at SFH, Riyadh.
Secondary objectives: To assess the most common causes, symptoms and prevalence of hypoglycemia among type 2 diabetes patients in SFH.
Methods: Cross-sectional study among Type 2 diabetic patients visiting the diabetes centre clinics at SFH in 2017
Results: Of 386 participants, 237 participants (61.4%) had good knowledge of hypoglycemia, but only 149 participants (38.6%) had poor knowledge. The mean age, weight and height of participants were 53.7±13.5 years, 80±27.2 Kg and 158± 21 cm. According to participants' opinion about the most common cause of hypoglycemia is exertion (68.7%) and most common symptom of hypoglycemia is dizziness (74.6%).239 (61.9%) experienced a hypoglycemic event in the last three months; and, the majority of them, 126 (52.7%) had less than three times attacks of hypoglycemia, and only 107 (27.7%) had no previous hypoglycemia in the last three months.
Conclusion: Participants had good knowledge about hypoglycemia and its preventive method. However, increasing incidence of hypoglycemic events needs more diabetes education programs to apply their knowledge on a daily routine.
Keywords: Diabetes, hypoglycemia, type 2, symptoms, prevalence.
References
- Association, A.D., Defining and reporting hypoglycemia in diabetes: a report from the American Diabetes Association Workgroup on Hypoglycemia. Diabetes Care, 2005. 28(5): p. 1245-1249.
- EMA, C., Guideline on similar biological medicinal products containing monoclonal antibodies–non-clinical and clinical issues: http://www. ema. Europe. eu/docs/en_GB/document_library/Scientific_guideline/2012/06/WC500128686. pdf. 2012, EMA/CHMP/BMWP/403543/2010. London, 30 May.
- Noh, R.M., A.J. Graveling, and B.M. Frier, Medically minimising the impact of hypoglycaemia in type 2 diabetes: a review. Expert opinion on pharmacotherapy, 2011. 12(14): p. 2161-2175.
- Griesdale, D.E., et al., Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data. Canadian Medical Association Journal, 2009. 180(8): p. 821-827.
- Kalra, S., et al., Hypoglycemia: The neglected complication. Indian journal of endocrinology and metabolism, 2013. 17(5): p. 819.
- Lundkvist, J., et al., The economic and quality of life impact of hypoglycemia. The European journal of health economics, 2005. 6(3): p. 197-202.
- Jönsson, L., B. Bolinder, and J. Lundkvist, Cost of hypoglycemia in patients with Type 2 diabetes in Sweden. Value in health, 2006. 9(3): p. 193-198.
- Abbatecola, A.M., et al., Severe hypoglycemia is associated with antidiabetic oral treatment compared with insulin analogs in nursing home patients with type 2 diabetes and dementia: results from the DIMORA study. J Am Med Dir Assoc, 2015. 16(4): p. 349 e7-12.
- Leese, G.P., et al., Frequency of severe hypoglycemia requiring emergency treatment in type 1 and type 2 diabetes: a population-based study of health service resource use. Diabetes care, 2003. 26(4): p. 1176-1180.
- Akram, K., et al., Frequency and risk factors of severe hypoglycaemia in insulin‐treated Type 2 diabetes: a cross‐sectional survey. Diabetic medicine, 2006. 23(7): p. 750-756.
- Aronson, R., et al., The Canadian Hypoglycemia Assessment Tool Program: Insights Into Rates and Implications of Hypoglycemia From an Observational Study. Can J Diabetes, 2018. 42(1): p. 11-17.
- Larijani, B., Journal of diabetes and metabolic disorders: launch editorial. 2012, BioMed Central.
- Kedia, N., Treatment of severe diabetic hypoglycemia with glucagon: an underutilized therapeutic approach. Diabetes, metabolic syndrome and obesity: targets and therapy, 2011. 4: p. 337. .
- Shriraam V, Mahadevan S, Anitharani M, Jagadeesh NS, Kurup SB, Vidya TA, Seshadri KG. Knowledge of hypoglycemia and its associated factors among type 2 diabetes mellitus patients in a tertiary care hospital in South India. Indian journal of endocrinology and metabolism. 2015 May;19(3):378
- Alanazi AM, el-Fetoh NM, Alotaibi HK, Alanazi KA, Alotaibi BK, Alshammari SM, Alanazi SR, Alhazmi MD, Alshammari YT, Alshammari ZQ. Survey of awareness of diabetes mellitus among the Arar population, Northern Border Region of Saudi Arabia. Electronic physician. 2017 Sep;9(9):5369.
- Federation, I.D., IDF diabetes atlas–7th edition. 2015.
- Rowe, B.H., et al., Acute management and outcomes of patients with diabetes mellitus presenting to Canadian emergency departments with hypoglycemia. Can J Diabetes, 2015. 39 Suppl 4: p. 9-18.
- Cha, S.A., et al., Severe Hypoglycemia and Cardiovascular or All-Cause Mortality in Patients with Type 2 Diabetes. Diabetes Metab J, 2016. 40(3): p. 202-10.
- Gillies, C.L., et al., Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. Bmj, 2007. 334(7588): p. 299.
- Lindström, J., et al., The Finnish Diabetes Prevention Study (DPS): Lifestyle intervention and 3-year results on diet and physical activity. Diabetes care, 2003. 26(12): p. 3230-3236.
- Prevention, D., Programme (DPP) Research Group. The Diabetes Prevention Program (DPP). Description of lifestyle intervention. Diabetes Care, 2002. 25: p. 2165-2171.
- Takai, M., et al., A case of hypothalamic hypopituitarism accompanied by recurrent severe hypoglycemia. Springerplus, 2015. 4: p. 173.
- Dalal, M.R., et al., Hypoglycemia After Initiation of Basal Insulin in Patients with Type 2 Diabetes in the United States: Implications for Treatment Discontinuation and Healthcare Costs and Utilization. Adv Ther, 2017. 34(9): p. 2083-2092.
- Miller, C.D., et al., Hypoglycemia in patients with type 2 diabetes mellitus. Archives of internal medicine, 2001. 161(13): p. 1653-1659.
- Davis, R.E., et al., Impact of hypoglycaemia on quality of life and productivity in type 1 and type 2 diabetes. Current medical research and opinion, 2005. 21(9): p. 1477-1483.
- Feher, M.D., H. Langerman, and M. Evans, Hypoglycemia, diabetes therapies and driving categories in type 2 diabetes. Curr Med Res Opin, 2016. 32(6): p. 1005-12.
- Reifegerste, D. and S. Hartleib, Hypoglycemia-related information seeking among informal caregivers of type 2 diabetes patients: Implications for health education. J Clin Transl Endocrinol, 2016. 4: p. 7-12
Corresponding Author
Naif Mohammed Albaqami
Family Medicine Resident
DOI: https://dx.doi.org/10.18535/jmscr/v6i10.01
