Concerns about hypoglycaemia and late complications in patients with insulin-treated diabetes
DOI:
https://doi.org/10.1002/edn.91Keywords:
Type 1 diabetes, type 2 diabetes, insulin therapy, hypoglycaemia, late diabetic complications, worries, fear, hypoglycaemia awarenessAbstract
AbstractBackground: Diabetes-related anxiety influences the quality-of-life of people with diabetes.
Aim: To compare diabetes-related concerns in insulin-treated patients with type 1 and type 2 diabetes.
Method: A cross-sectional questionnaire survey was carried out in two cohorts of adult outpatients with type 1 diabetes (n=223) and insulin-treated type 2 diabetes (n=104). Assessment of concerns about mild and severe hypoglycaemia, blindness and kidney failure was carried out using the seven-point Likert scale.
Results: Insulin-treated patients with type 1 or 2 diabetes worry mostly about late diabetic complications, less about severe hypoglycaemia and little about mild hypoglycaemia. Patients with type 1 diabetes worry more about severe hypoglycaemia than those with type 2 diabetes; no differences in levels of anxiety about mild hypoglycaemia, blindness and kidney failure exist. Severe hypoglycaemia in the preceding year is associated with more worry about severe hypoglycaemia in patients with type 1 or 2 diabetes. Those with type 1 or 2 diabetes who have impaired awareness of hypoglycaemia tend to worry more about severe hypoglycaemia than those with normal awareness of hypoglycaemia. The presence of eye or kidney complications does not influence the level of anxiety in people with type 1 diabetes. Patients with type 2 diabetes without complications tend to worry more about mild and severe hypoglycaemia than those with complications.
Conclusion: Patients with insulin-treated diabetes worry considerably about microvascular complications and severe hypoglycaemia risk. Recent experience of severe hypoglycaemia and presence of impaired hypoglycaemia awareness are associated with increased worry scores for severe hypoglycaemia in patients with type 1 or 2 diabetes. Screening for diabetes-related concerns should be integrated into diabetes care.
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