OBJECTIVES: Generic preference-based measures, such as the SF-36 and EQ-5D, are used to assess health-related quality of life (HRQoL). It is unclear how these measures perform in real-world samples of individuals with type 1 diabetes (T1D) experiencing severe hypoglycemic events (SHE) and impaired awareness of hypoglycemia (IAH), which this study aims to investigate.

METHODS: Adult continuous glucose monitor (CGM) users (aged ≥18 years) from the T1D Exchange Registry with a self-reported T1D diagnosis completed an online survey to quantify HRQoL using the SF-36 and EQ-5D-5L. Cohorts were created based on SHE frequency in the past 12 months and the presence/absence of IAH (modified Gold score): recurrent SHE (2+ SHE/IAH+), problematic SHE (2+ SHE/IAH-; 1+ SHE/IAH+), single SHE/no IAH (1 SHE/IAH-), and no SHE (0 SHE/IAH+; 0 SHE/IAH-). Descriptive analyses (mean [standard deviation (SD)]) of characteristics and HRQoL impacts are reported overall and by SHE cohort.

RESULTS: The analytic cohort comprised 1,510 participants, including recurrent SHE (n=174), problematic SHE (n=201), single SHE/no IAH (n=102), and no SHE (n=1,033) cohorts. Participants’ mean age was 46.4 years (SD: 15.4) and most were female (66.3%). Mean duration of T1D diagnosis was 29.4 years (SD: 15.2). Participants reported 1.9 mean SHE (SD: 14.2) in the past year and 41.1% had IAH+ (Gold score: ≥4). The recurrent SHE cohort reported the lowest SF-36 scores across all domains. Domains with the greatest mean (SD) impact were role functioning/physical (recurrent SHE: 42.2 [39.8] vs. no SHE: 70.0 [37.3]), role functioning/emotional (53.3 [41.3] vs. 70.4 [38.0]), pain (59.9 [25.3] vs. 77.0 [20.9]). EQ-5D-5L also showed varied impact in observed means between cohorts and across domains within cohorts; greatest difference was observed between recurrent SHE and no SHE cohorts (EQ-5D-5L VAS: 64.8 [SD: 23.2] vs. 76.1 [SD: 18.0]).

CONCLUSIONS: Findings suggest greater negative impacts of HRQoL on adults experiencing recurrent severe hypoglycemia.