New global research reveals that over three quarters (76%) of people with diabetes surveyed who had experienced nocturnal hypoglycaemia are worried about these events.1 The World Awake research found that those surveyed had experienced an average of three night time events in the previous 30 days that they could treat themselves.1 Of those who worried about these events, three quarters (75%) stated that the worry impacted their sleep and one in five (19%) said that it caused them severe sleep disturbances or insomnia.1
Despite their frequency and their negative impact upon those that suffer with them, the survey also showed that nocturnal hypoglycaemic events go under reported. Nearly half (49%) of those surveyed did not discuss them with their primary care physician, general practitioner (GP) or family doctor.1 Additionally, a fifth (20%) did not discuss these events with any healthcare professional at all.1
"It is disturbing to see the significant negative impact on general wellbeing and treatment satisfaction that having and/or worrying about nocturnal hypoglycaemic events has on patients and the number of these events not being reported," said Professor Anthony Barnett, Professor of Medicine, Consultant Physician and Clinical Director of Diabetes and Endocrinology at Heart of England NHS Foundation Trust, Birmingham, UK.
"It is often easy for both physicians and patients to dismiss non-specific symptoms and tiredness as due to other factors. More proactive monitoring for symptoms and signs of nocturnal hypoglycaemic events by patients should be encouraged and this coupled with enhanced education and support should ensure health care professionals are able to make the most informed management decisions in consultation with their patients."
Nocturnal hypoglycaemia can be serious and even self-treated events have been shown to have a significant impact on functioning of people with diabetes, including the quality and amount of sleep.2 Sleep disruption (and resulting sleep deprivation for some) can not only impair glucose tolerance,3 but can also lead to increased body mass index and obesity,4 higher blood pressure and development of hypertension,5,6 and cardiovascular disease.7,8
A lack of awareness or understanding about the significance of nocturnal hypoglycaemic events among people with diabetes may explain some of these findings. Respondents noted that they had not discussed their events with their primary care physician for a number of reasons including not feeling they were relevant or important enough (23%) and not wanting to waste their physician's time (10%).1 Thirteen percent felt their GP or primary care physician knew or assumed these events were taking place.
A combination of lifestyle changes and optimising insulin treatment may help to reduce both the frequency and impact of nocturnal hypoglycaemic events. However, 37% of survey respondents reported managing their diabetes with only insulin and no lifestyle changes (defined as diet and exercise).1 Further, concern about these events impacted how respondents self-managed their condition, including increasing the frequency of their blood glucose monitoring (49%), changing what they ate throughout the day (42%), reducing their insulin dose/s (39%) or even missing insulin dose/s altogether (20%).1
The research was published as part of The World Awake campaign, a new global education initiative from Novo Nordisk, supported by the International Diabetes Federation (IDF). It aims to raise awareness of the impact of nocturnal hypoglycaemia on people with diabetes amongst GPs and primary care physicians and to encourage more proactive conversations about them.
"We are delighted to support The World Awake campaign," said Sir Michael Hirst, President of the IDF. "GPs and primary care physicians are often at the heart of the multi-disciplinary team of healthcare professionals helping those with diabetes to manage their condition. They are ideally placed to educate patients on nocturnal hypoglycaemia and help them understand the significance of these events."