Impact of the severity of hypoglycemia on health - Related quality of life, productivity, resource use, and costs among US patients with type 2 diabetes

J Diabetes Complications. 2018 May;32(5):451-457. doi: 10.1016/j.jdiacomp.2018.01.012. Epub 2018 Feb 2.

Abstract

Aims: To explore the association between hypoglycemia severity and health-related quality of life (HRQoL), productivity, health care resource utilization (HCRU), and costs among patients with type 2 diabetes mellitus (T2DM).

Methods: Data were from the 2013 US National Health and Wellness Survey. This analysis included adults with treated T2DM. Participants were categorized based upon their self-reported experience in the previous 3 months: no hypoglycemia, non-severe hypoglycemia, or severe hypoglycemia. Validated instruments were used to measure HRQoL and productivity; HCRU was based on participant-reported health care provider (HCP) and emergency department (ED) visits and hospitalizations. Multivariable models tested for trends across the severity groups.

Results: The analysis included 3630 participants-1729 (47.6%) with non-severe hypoglycemia and 172 (4.7%) with severe hypoglycemia. Mental and physical component scores and utility scores were significantly associated with hypoglycemia severity (P < 0.001 for each). Similar trends were observed for absenteeism (P < 0.001), presenteeism (P = 0.005), HCP and ED visits (P ≤ 0.002), and hospitalizations (P < 0.001). Annual HCRU costs associated with increasingly severe hypoglycemia were $6908, $7132, and $15,410, respectively (P < 0.001), and productivity costs were $7248, $7493, and $12,167, respectively (P = 0.008).

Conclusion: Hypoglycemia severity appears to be related to reduced HRQoL and productivity, which are mirrored by increased direct and indirect costs.

Keywords: Diabetes mellitus, type 2; Employment; Health care costs; Health resources; Hypoglycemia; Quality of life.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absenteeism*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cost of Illness*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / economics
  • Diabetes Mellitus, Type 2* / epidemiology
  • Employment / economics
  • Employment / statistics & numerical data
  • Female
  • Health Care Costs / statistics & numerical data*
  • Health Resources / economics
  • Health Resources / statistics & numerical data*
  • Health Surveys
  • Humans
  • Hypoglycemia* / chemically induced
  • Hypoglycemia* / economics
  • Hypoglycemia* / epidemiology
  • Hypoglycemia* / pathology
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use
  • Male
  • Middle Aged
  • Quality of Life*
  • Severity of Illness Index
  • United States / epidemiology
  • Young Adult

Substances

  • Hypoglycemic Agents