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. 2018 Apr 24;6(1):e000503.
doi: 10.1136/bmjdrc-2017-000503. eCollection 2018.

Real-world crude incidence of hypoglycemia in adults with diabetes: Results of the InHypo-DM Study, Canada

Alexandria Ratzki-Leewing  1 , Stewart B Harris  1   2 , Selam Mequanint  2 , Sonja M Reichert  2 , Judith Belle Brown  2 , Jason Edward Black  1 , Bridget L Ryan  1   2
Affiliations

Real-world crude incidence of hypoglycemia in adults with diabetes: Results of the InHypo-DM Study, Canada

Alexandria Ratzki-Leewing et al. BMJ Open Diabetes Res Care. .

Abstract

Objective: Very few real-world studies have been conducted to assess the incidence of diabetes-related hypoglycemia. Moreover, there is a paucity of studies that have investigated hypoglycemia among people taking secretagogues as a monotherapy or in combination with insulin. Accordingly, our research team developed and validated the InHypo-DM Person with Diabetes Mellitus Questionnaire (InHypo-DMPQ) with the aim of capturing the real-world incidence of self-reported, symptomatic hypoglycemia. The questionnaire was administered online to a national sample of Canadians (≥18 years old) with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) treated with insulin and/or insulin secretagogues.

Research design and methods: Self-report data obtained from the InHypo-DMPQ were descriptively analyzed to ascertain the crude incidence proportions and annualized incidence densities (rates) of 30-day retrospective non-severe and 1-year retrospective severe hypoglycemia, including daytime and nocturnal events.

Results: A total of 552 people (T2DM: 83%; T1DM: 17%) completed the questionnaire. Over half (65.2%) of the total respondents reported experiencing at least one event (non-severe or severe) at an annualized crude incidence density of 35.1 events per person-year. The incidence proportion and rate of non-severe events were higher among people with T1DM versus T2DM (77% and 55.7 events per person-year vs 54% and 28.0 events per person-year). Severe hypoglycemia was reported by 41.8% of all respondents, at an average rate of 2.5 events per person-year.

Conclusions: The results of the InHypo-DMPQ, the largest real-world investigation of hypoglycemia epidemiology in Canada, suggest that the incidence of hypoglycemia among adults with diabetes taking insulin and/or insulin secretagogues is higher than previously thought.

Keywords: InHypo-DM; diabetes mellitus; hypoglycemia; incidence.

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Conflict of interest statement

Competing interests: SBH: Sanofi: grant, personal fees, member advisory board, consultant; Eli Lilly: grant, personal fees, member advisory board, consultant, clinical studies; Novo Nordisk: grant, personal fees, member advisory board, consultant, clinical studies; Janssen: grant, personal fees, member advisory board, consultant; Merck: personal Fees, member advisory board, consultant; AstraZeneca: grant, personal fees, member advisory board, consultant, clinical studies; Abbott: grant, personal fees, member advisory board, consultant; Boehringer Ingelheim: grant, personal fees, member advisory board, consultant, clinical studies; JDRF: grant; Lawson: grant; Medtronic: personal fees, member advisory board; Amgen: personal fees, member advisory board; Health Canada/First Nations and Inuit Health Branch: grant. SMR: Sanofi: grant, coinvestigator for clinical trials (but with no direct monies for me), fees for presentations; AstraZeneca: grant, coinvestigator for clinical trials (but with no direct monies for me), fees for presentations; Novo Nordisk: grant, coinvestigator of clinical trials, with travel for meetings (but no direct grant monies for me), fees paid for presentations; Boehringer Ingelheim: grant, coinvestigator for clinical trials (but with no direct monies for me), fees for presentations; Servier: grant, coinvestigator of clinical trials, with travel for meetings (but no direct grant monies for me), fees paid for presentations; Janssen: fees paid for presentations; Eli Lilly: fees paid for presentations; Merck: fees paid for presentations; Abbott: fees paid for presentations.

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