Factors and economic burden of non-severe hypoglycemia among insulin-treated type 2 diabetes patients: a cross-sectional study.

OBJECTIVE: This cross-sectional survey was performed to assess the prevalence, factors, and economic burden of non-severe hypoglycemia among insulin-treated type 2 diabetes (T2D) patients in the northern Thailand.

METHODS: Between April 2021 to August 2022, 600 participants were evaluated via structured questionnaires containing sociodemographic and clinical characteristics, medications, and economic burden. Patients were divided into 2 groups (having and not having non-severe hypoglycemia). Variables with p value < 0.05 in the univariate model were included in the multivariate model.

RESULTS: The percentage of non-severe hypoglycemia was 50.3% (302/600). Of all participants, average age was 61.4 ± 26.0 years, 55.7% were female, 53.5% used premix insulin, and average duration of diabetes was 16.1 ± 10.0 years. Multivariate logistic regression analysis indicated that age (OR 0.96; p  < 0.001), duration of diabetes (OR 1.04; p  < 0.001), BMI (OR 0.95; p  = 0.002), thiazolidinedione (OR 1.56; p  = 0.012) and insulin regimens were associated with having non-severe hypoglycemia. Compared to basal insulin, basal bolus (OR 6.93; p  = 0.001), basal plus (OR 3.58; p  < 0.001), and premix insulin (OR 1.83; p  = 0.003) were associated with hypoglycemia. Greater numbers of sick leave were found in hypoglycemia group (14 vs 4 patients, p = 0.029). Conclusions: These findings help to individuate those patients who are at higher risk of non-severe hypoglycemia in insulin-treated T2D patients. Compared to non-hypoglycemia group, patients with hypoglycemia were younger, had longer diabetes duration, lower BMI, received thiazolidinedione and insulin regimens such as premix, basal plus, or basal bolus insulins, and more productivity loss.