Endocrine Abstracts

Background: The prevalence of diabetes has reached epidemic proportions and according to the World Health Organisation (WHO) more than 220 million people worldwide have diabetes. The main complication in insulin-dependent diabetes mellitus (IDDM) patients is hypoglycaemia, with approximately 90% of all IDDM patients having experienced a hypoglycaemic episode. Hypoglycaemia has a substantial clinical impact in terms of mortality, morbidity and quality of life.

Methods: A systematic search of MEDINE and EMBASE was performed for all relevant published articles. Reference lists of all included studies were also searched. Studies were included assessing fear of hypoglycaemia, recognition of symptoms, health-seeking behaviour and impact on overall wellbeing. One reviewer screened abstracts of all identified citations, selected potentially eligible studies and assessed their full-text versions using the STROBE (Strengthening the reporting of observational studies in epidemiology) checklist for cohort, case-control and cross-sectional studies (combined.) Findings from the studies were then narratively synthesized.

Results: Eight studies were included in this review. After hypoglycaemia, IDDM patients have significantly (o<0.01) raised fears of future hypoglycaemia, more fatigue, reduced alertness and a negative impact on health-related quality of life (HRQL.)

Conclusion: Hypoglycaemia has a wide range of negative emotional, social and behavioural consequences on IDDM patients. These impacts, hence are a major barrier to IDDM patients achieving optimal glycaemic control. There remains a need for a large multi-country study that incorporates mixed-methods data collection, including a qualitative aspect to provide more in-depth views of the effects of hypoglycaemia.