J Clin Outcomes Manage
The burden of hypoglycemia in type 2 diabetes: a systematic review of patient and economic perspectives
Zhang Y, Wieffer H, Modha R, Balar B, Pollack M, Krishnarajah G
Abstract: Objective: To identify the magnitude of the burden of hypoglycemia in type 2 diabetes. Methods: Studies that reported data on the economic burden, impact on quality of life (QOL), or treatment satisfaction related to hypoglycemia in a type 2 diabetes population were identified from searches of literature databases and conference proceedings and reviewed. Results: Studies showed that hypoglycemia had a detrimental effect on QOL as measured by generic QOL instruments (EQ-5D, SF-36) and diminished treatment satisfaction levels among patients treated with oral antidiabetic agents (OADs), although the latter was not observed in insulin-treated patients. Previous hypoglycemia also increased fear of the condition among OAD-treated patients as measured by the Hypoglycemia Fear Scale. Hypoglycemia in OAD-treated patients was associated with decreased work productivity. Detailed evidence of the medical cost burden of hypoglycemic events was identified in 5 US studies of insulin-treated patients. Individual episodes requiring hospital admission were identified as particularly costly from the perspective of medical payers in both US and international studies. The higher frequency of less severe events together with their potential to significantly affect work productivity point to their importance from a payer and societal perspective. Conclusion: In light of the impact on the patient and wider society in economic as well as clinical terms, consideration of hypoglycemia should be an important part of clinical decision making.
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