The impact of hypoglycaemia on daily functioning among adults with diabetes: a prospective observational study using the Hypo-METRICS App

Uffe Søholm; Melanie M. Broadley; Natalie Zaremba; Patrick Divilly; Petra Martina Baumann; Zeinab Mahmoudi; Gilberte Martine-Edith; Julia K. Mader; Monika Cigler; Julie Maria Bøggild Brøsen; Allan Vaag; Simon Heller; Ulrik Pedersen-Bjergaard; Rory J. McCrimmon; Eric Renard; Mark Evans; Bastiaan E. de Galan; Evertine Abbink; Stephanie A. Amiel; Christel Hendrieckx; Jane Speight; Pratik Choudhary; Frans Pouwer; Hypo-RESOLVE Consortium

doi:10.1007/s00125-024-06233-1

The impact of hypoglycaemia on daily functioning among adults with diabetes: a prospective observational study using the Hypo-METRICS App

Uffe Søholm (Lead / Corresponding author), Melanie M. Broadley, Natalie Zaremba, Patrick Divilly, Petra Martina Baumann, Zeinab Mahmoudi, Gilberte Martine-Edith, Julia K. Mader, Monika Cigler, Julie Maria Bøggild Brøsen, Allan Vaag, Simon Heller, Ulrik Pedersen-Bjergaard, Rory J. McCrimmon, Eric Renard, Mark Evans, Bastiaan E. de Galan, Evertine Abbink, Stephanie A. Amiel, Christel HendrieckxJane Speight, Pratik Choudhary, Frans Pouwer, Hypo-RESOLVE Consortium

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Abstract

Aims/hypothesis The aim of this work was to examine the impact of hypoglycaemia on daily functioning among adults with type 1 diabetes or insulin-treated type 2 diabetes, using the novel Hypo-METRICS app.

Methods For 70 consecutive days, 594 adults (type 1 diabetes, n=274; type 2 diabetes, n=320) completed brief morning and evening Hypo-METRICS ‘check-ins’ about their experienced hypoglycaemia and daily functioning. Participants wore a blinded glucose sensor (i.e. data unavailable to the participants) for the study duration. Days and nights with or without person-reported hypoglycaemia (PRH) and/or sensor-detected hypoglycaemia (SDH) were compared using multilevel regression models.

Results Participants submitted a mean ± SD of 86.3±12.5% morning and 90.8±10.7% evening check-ins. For both types of diabetes, SDH alone had no significant associations with the changes in daily functioning scores. However, daytime and night-time PRH (with or without SDH) were significantly associated with worsening of energy levels, mood, cognitive functioning, negative affect and fear of hypoglycaemia later that day or while asleep. In addition, night-time PRH (with or without SDH) was significantly associated with worsening of sleep quality (type 1 and type 2 diabetes) and memory (type2 diabetes). Further, daytime PRH (with or without SDH), was associated with worsening of fear of hyperglycaemia while asleep (type 1 diabetes), memory (type 1 and type 2 diabetes) and social functioning (type 2 diabetes).

Conclusions/interpretation This prospective, real-world study reveals impact on several domains of daily functioning following PRH but not following SDH alone. These data suggest that the observed negative impact is mainly driven by subjective awareness of hypoglycaemia (i.e. PRH), through either symptoms or sensor alerts/readings and/or the need to take action to prevent or treat episodes.

Original language	English
Pages (from-to)	2160-2174
Number of pages	15
Journal	Diabetologia
Volume	67
DOIs	https://doi.org/10.1007/s00125-024-06233-1
Publication status	Published - 30 Jul 2024

Keywords

hypoglycaemia
quality of life
daily functioning
Ecological momentary assessment
Daily functioning
Hypoglycaemia
Quality of life

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00125-024-06233-1Licence: CC BY

Final Published VersionFinal published version, 3.06 MBLicence: CC BY

Cite this

Søholm, U., Broadley, M. M., Zaremba, N., Divilly, P., Baumann, P. M., Mahmoudi, Z., Martine-Edith, G., Mader, J. K., Cigler, M., Brøsen, J. M. B., Vaag, A., Heller, S., Pedersen-Bjergaard, U., McCrimmon, R. J., Renard, E., Evans, M., de Galan, B. E., Abbink, E., Amiel, S. A., ... Hypo-RESOLVE Consortium (2024). The impact of hypoglycaemia on daily functioning among adults with diabetes: a prospective observational study using the Hypo-METRICS App. Diabetologia, 67, 2160-2174. https://doi.org/10.1007/s00125-024-06233-1

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abstract = "Aims/hypothesis The aim of this work was to examine the impact of hypoglycaemia on daily functioning among adults with type 1 diabetes or insulin-treated type 2 diabetes, using the novel Hypo-METRICS app.Methods For 70 consecutive days, 594 adults (type 1 diabetes, n=274; type 2 diabetes, n=320) completed brief morning and evening Hypo-METRICS {\textquoteleft}check-ins{\textquoteright} about their experienced hypoglycaemia and daily functioning. Participants wore a blinded glucose sensor (i.e. data unavailable to the participants) for the study duration. Days and nights with or without person-reported hypoglycaemia (PRH) and/or sensor-detected hypoglycaemia (SDH) were compared using multilevel regression models.Results Participants submitted a mean ± SD of 86.3±12.5% morning and 90.8±10.7% evening check-ins. For both types of diabetes, SDH alone had no significant associations with the changes in daily functioning scores. However, daytime and night-time PRH (with or without SDH) were significantly associated with worsening of energy levels, mood, cognitive functioning, negative affect and fear of hypoglycaemia later that day or while asleep. In addition, night-time PRH (with or without SDH) was significantly associated with worsening of sleep quality (type 1 and type 2 diabetes) and memory (type2 diabetes). Further, daytime PRH (with or without SDH), was associated with worsening of fear of hyperglycaemia while asleep (type 1 diabetes), memory (type 1 and type 2 diabetes) and social functioning (type 2 diabetes).Conclusions/interpretation This prospective, real-world study reveals impact on several domains of daily functioning following PRH but not following SDH alone. These data suggest that the observed negative impact is mainly driven by subjective awareness of hypoglycaemia (i.e. PRH), through either symptoms or sensor alerts/readings and/or the need to take action to prevent or treat episodes.",

keywords = "hypoglycaemia, quality of life, daily functioning, Ecological momentary assessment, Daily functioning, Hypoglycaemia, Quality of life",

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doi = "10.1007/s00125-024-06233-1",

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Søholm, U, Broadley, MM, Zaremba, N, Divilly, P, Baumann, PM, Mahmoudi, Z, Martine-Edith, G, Mader, JK, Cigler, M, Brøsen, JMB, Vaag, A, Heller, S, Pedersen-Bjergaard, U, McCrimmon, RJ, Renard, E, Evans, M, de Galan, BE, Abbink, E, Amiel, SA, Hendrieckx, C, Speight, J, Choudhary, P, Pouwer, F & Hypo-RESOLVE Consortium 2024, 'The impact of hypoglycaemia on daily functioning among adults with diabetes: a prospective observational study using the Hypo-METRICS App', Diabetologia, vol. 67, pp. 2160-2174. https://doi.org/10.1007/s00125-024-06233-1

TY - JOUR

T1 - The impact of hypoglycaemia on daily functioning among adults with diabetes

T2 - a prospective observational study using the Hypo-METRICS App

AU - Søholm, Uffe

AU - Broadley, Melanie M.

AU - Zaremba, Natalie

AU - Divilly, Patrick

AU - Baumann, Petra Martina

AU - Mahmoudi, Zeinab

AU - Martine-Edith, Gilberte

AU - Mader, Julia K.

AU - Cigler, Monika

AU - Brøsen, Julie Maria Bøggild

AU - Vaag, Allan

AU - Heller, Simon

AU - Pedersen-Bjergaard, Ulrik

AU - McCrimmon, Rory J.

AU - Renard, Eric

AU - Evans, Mark

AU - de Galan, Bastiaan E.

AU - Abbink, Evertine

AU - Amiel, Stephanie A.

AU - Hendrieckx, Christel

AU - Speight, Jane

AU - Choudhary, Pratik

AU - Pouwer, Frans

AU - Hypo-RESOLVE Consortium

PY - 2024/7/30

Y1 - 2024/7/30

N2 - Aims/hypothesis The aim of this work was to examine the impact of hypoglycaemia on daily functioning among adults with type 1 diabetes or insulin-treated type 2 diabetes, using the novel Hypo-METRICS app.Methods For 70 consecutive days, 594 adults (type 1 diabetes, n=274; type 2 diabetes, n=320) completed brief morning and evening Hypo-METRICS ‘check-ins’ about their experienced hypoglycaemia and daily functioning. Participants wore a blinded glucose sensor (i.e. data unavailable to the participants) for the study duration. Days and nights with or without person-reported hypoglycaemia (PRH) and/or sensor-detected hypoglycaemia (SDH) were compared using multilevel regression models.Results Participants submitted a mean ± SD of 86.3±12.5% morning and 90.8±10.7% evening check-ins. For both types of diabetes, SDH alone had no significant associations with the changes in daily functioning scores. However, daytime and night-time PRH (with or without SDH) were significantly associated with worsening of energy levels, mood, cognitive functioning, negative affect and fear of hypoglycaemia later that day or while asleep. In addition, night-time PRH (with or without SDH) was significantly associated with worsening of sleep quality (type 1 and type 2 diabetes) and memory (type2 diabetes). Further, daytime PRH (with or without SDH), was associated with worsening of fear of hyperglycaemia while asleep (type 1 diabetes), memory (type 1 and type 2 diabetes) and social functioning (type 2 diabetes).Conclusions/interpretation This prospective, real-world study reveals impact on several domains of daily functioning following PRH but not following SDH alone. These data suggest that the observed negative impact is mainly driven by subjective awareness of hypoglycaemia (i.e. PRH), through either symptoms or sensor alerts/readings and/or the need to take action to prevent or treat episodes.

AB - Aims/hypothesis The aim of this work was to examine the impact of hypoglycaemia on daily functioning among adults with type 1 diabetes or insulin-treated type 2 diabetes, using the novel Hypo-METRICS app.Methods For 70 consecutive days, 594 adults (type 1 diabetes, n=274; type 2 diabetes, n=320) completed brief morning and evening Hypo-METRICS ‘check-ins’ about their experienced hypoglycaemia and daily functioning. Participants wore a blinded glucose sensor (i.e. data unavailable to the participants) for the study duration. Days and nights with or without person-reported hypoglycaemia (PRH) and/or sensor-detected hypoglycaemia (SDH) were compared using multilevel regression models.Results Participants submitted a mean ± SD of 86.3±12.5% morning and 90.8±10.7% evening check-ins. For both types of diabetes, SDH alone had no significant associations with the changes in daily functioning scores. However, daytime and night-time PRH (with or without SDH) were significantly associated with worsening of energy levels, mood, cognitive functioning, negative affect and fear of hypoglycaemia later that day or while asleep. In addition, night-time PRH (with or without SDH) was significantly associated with worsening of sleep quality (type 1 and type 2 diabetes) and memory (type2 diabetes). Further, daytime PRH (with or without SDH), was associated with worsening of fear of hyperglycaemia while asleep (type 1 diabetes), memory (type 1 and type 2 diabetes) and social functioning (type 2 diabetes).Conclusions/interpretation This prospective, real-world study reveals impact on several domains of daily functioning following PRH but not following SDH alone. These data suggest that the observed negative impact is mainly driven by subjective awareness of hypoglycaemia (i.e. PRH), through either symptoms or sensor alerts/readings and/or the need to take action to prevent or treat episodes.

KW - hypoglycaemia

KW - quality of life

KW - daily functioning

KW - Ecological momentary assessment

KW - Daily functioning

KW - Hypoglycaemia

KW - Quality of life

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DO - 10.1007/s00125-024-06233-1

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SN - 0012-186X

VL - 67

SP - 2160

EP - 2174

JO - Diabetologia

JF - Diabetologia

ER -

The impact of hypoglycaemia on daily functioning among adults with diabetes: a prospective observational study using the Hypo-METRICS App

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Hypoglycaemia - REdefining SOLutions for better liVEs (Hypo-RESOLVE) (Joint with Stichting Katholieke Universiteit, King's College London, Medizinische Universitat Graz and 19 others)

Cite this

The impact of hypoglycaemia on daily functioning among adults with diabetes: a prospective observational study using the Hypo-METRICS App

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Projects

Hypoglycaemia - REdefining SOLutions for better liVEs (Hypo-RESOLVE) (Joint with Stichting Katholieke Universiteit, King's College London, Medizinische Universitat Graz and 19 others)

Cite this