Impact of severe hypoglycaemia on psychological outcomes in adults with Type 2 diabetes: a systematic review
Corresponding Author
C. Hendrieckx
School of Psychology, Deakin University, Geelong, Victoria, Australia
The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
Correspondence to: Christel Hendrieckx. E-mail: [email protected]Search for more papers by this authorN. Ivory
School of Psychology, Deakin University, Geelong, Victoria, Australia
Search for more papers by this authorH. Singh
Mary & Dick Allen Diabetes Center, Hoag Memorial Hospital Presbyterian, Newport Beach, CA, USA
Search for more papers by this authorB. M. Frier
The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
Search for more papers by this authorJ. Speight
School of Psychology, Deakin University, Geelong, Victoria, Australia
The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
Search for more papers by this authorCorresponding Author
C. Hendrieckx
School of Psychology, Deakin University, Geelong, Victoria, Australia
The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
Correspondence to: Christel Hendrieckx. E-mail: [email protected]Search for more papers by this authorN. Ivory
School of Psychology, Deakin University, Geelong, Victoria, Australia
Search for more papers by this authorH. Singh
Mary & Dick Allen Diabetes Center, Hoag Memorial Hospital Presbyterian, Newport Beach, CA, USA
Search for more papers by this authorB. M. Frier
The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
Search for more papers by this authorJ. Speight
School of Psychology, Deakin University, Geelong, Victoria, Australia
The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
Search for more papers by this authorAbstract
Aim
Hypoglycaemia affects many people with Type 2 diabetes using insulin and other glucose-lowering therapies. This systematic review examined the impact of severe hypoglycaemia (episodes requiring external assistance) on psychological outcomes (e.g. emotional well-being, health status and quality of life) in adults with Type 2 diabetes.
Methods
MEDLINE Complete, PsycINFO and CINAHL databases were searched for peer-reviewed empirical studies, published in English, reporting the occurrence and severity of hypoglycaemia and its relationship with patient-reported outcomes (PROs) in adults with Type 2 diabetes. Data were extracted from published reports and analysed.
Results
Of 3756 potentially relevant abstracts, 29 studies met the inclusion criteria. Most reported cross-sectional data and sample sizes varied widely (N = 71 to 17 563). Although definitions of mild and severe hypoglycaemia were largely consistent between studies, additional non-standard categorizations (e.g. moderate, very severe) were apparent and recall periods varied. Overall, severe hypoglycaemia was associated with increased fear of hypoglycaemia and decreased emotional well-being, health status and diabetes-specific quality of life. Effect sizes show that the association with fear of hypoglycaemia was stronger than with general health status.
Conclusions
Notwithstanding the limitations of the empirical studies, these findings indicate that severe hypoglycaemia in adults with Type 2 diabetes (insulin- and non-insulin-treated) is associated with impaired psychological outcomes. Healthcare professionals should address the psychological impact of severe hypoglycaemia during clinical consultations, to support individuals to minimize exposure to, and the psychological consequences of, severe hypoglycaemia.
Supporting Information
| Filename | Description |
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| dme14067-sup-0001-Supinfo.docxWord document, 69.5 KB |
Appendix S1. Search terms and search strategy. Appendix S2. Summary of patient reported outcome measures included. Table S1. Characteristics and key results of 29 studies selected for inclusion. Table S2. Effect sizes for hypoglycaemia severity levels and (a) fear of hypoglycaemia (HFS and Worry subscale) and (b) generic health status (EQ-VAS and EQ-5D). |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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