The impact of hypoglycaemia on daily functioning among adults with diabetes: a prospective observational study using the Hypo-METRICS Application

Aims/hypothesis: To examine the impact of hypoglycaemia on daily functioning among adults with type 1 diabetes or insulin-treated type 2 diabetes, using the novel Hypo-METRICS application. RESEARCH DESIGN AND METHODS For 70 consecutive days, 594 adults (type 1 diabetes: n=274; type 2diabetes: n=320) completed brief morning and evening Hypo-METRICS ‘check-ins’ about their experiencedhypoglycaemia and daily functioning. Participants wore a blinded glucose sensor for the study duration.Days   and   nights   with   or   without   person-reported   hypoglycaemia   (PRH)   and/or   sensor-detectedhypoglycaemia (SDH) were compared using multilevel regression models.  RESULTS  Participants submitted a mean of 86.3±12.5% morning and 90.8±10.7% evening check-ins.  Forboth types of diabetes, SDH alone had no significant associations to the changes in daily functioning scores.However, daytime and night-time PRH (with or without SDH) were significantly associated with worseningof   energy   levels,   mood,   cognitive   functioning,   negative   affect   and   fear   of   hypoglycaemia   later   thatday/while asleep. In addition, night-time PRH (with or without SDH) was significantly associated withworsening of sleep quality (type 1 and 2 diabetes), and memory (type 2 diabetes). Further, daytime PRH(with or without SDH), was associated with worsening of fear of hyperglycemia while asleep (type 1diabetes), memory (type 1 and 2 diabetes) and social functioning (type 2 diabetes). CONCLUSIONS This prospective, real-world study reveals impact on several domains of daily functioningfollowing PRH, but not following SDH alone.These data suggest that the observed negative impact is mainlydriven   by   subjective   awareness   of   hypoglycaemia   (i.e.,   PRH),   through   either   symptoms   or   sensoralerts/readings and/or the need to take action to prevent or treat them.