Author(s)
Simon D1, Bradley C2, Gönder-Frederick L3, Eschwège EM4, de Pablos-Velasco P5, Vandenberghe H6, Bouzamondo H7, Parhofer KG81Hôpital de la Pitié/INSERM U-1018, Paris, France, 2Royal Holloway, University of London, Surrey, United Kingdom, 3University of Virginia Health System, Charlottesville, VA, USA, 4INSERM, Villejuif, France, 5Dr Negrin Hospital, Las Palmas University, Las Palmas de Gran Canaria, Spain, 6AstraZeneca, Zaventem, Belgium, 7Bristol-Myers Squibb, Paris, France, 8Klinikum der Universität München, Munich, Germany
OBJECTIVES: Hypoglycaemia can be a side effect of glucose-lowering treatment in patients with type 2 diabetes (T2D) that may counterbalance the beneficial effects of diabetes control. PANORAMA is a large (n=5156) pan-European cross-sectional survey (NCT00916513) of patients assessing patient reported outcomes and glycaemic control. This subgroup analysis compared rates of severe and non-severe hypoglycaemic events in patients taking different pharmacological treatment regimens. METHODS: Patients with T2D were randomly or consecutively selected from medical practices in eight countries. Patients were aged ≥40 years, with T2D diagnosed >1 year and a clinic medical record available >1 year. All patients received dietary/exercise advice and most were also taking either oral antidiabetic drugs (OADs) and/or injectables (insulin and/or GLP-1 receptor agonists). Patients included in this subgroup analysis had been taking the same pharmacological treatment regimen for ≥12 months. Patient-reported frequency of severe (symptomatic episodes requiring external assistance) and non-severe hypoglycaemic episodes in the past year were examined. RESULTS: In this subgroup analysis 3106 patients were evaluated including: 1346 taking only OADs without secretagogues; 1452 taking only OADs including secretagogues (sulphonylurea/glinides) and 308 on insulin alone. The percentages of patients experiencing >1 non-severe hypoglycaemic episode in each treatment group were: 8.9% for patients taking OADs without secretagogues; 17.5% for patients taking OADs including secretagogues and 47.4% for patients using insulin alone. The differences between these three treatment categories (pair-wise comparisons) were highly significant (p<0.001). The percentage of patients reporting ≥1 severe hypoglycaemic episode was greater for OADs including secretagogues versus no secretagogues (3.0% versus 1.3%; p=0.011) and for insulin alone versus OADs including secretagogues (13.7% versus 3.0%; p<0.001). CONCLUSIONS: Among patients with T2D on glucose-lowering medication, rates of non-severe and severe hypoglycaemic episodes were lowest amongst patients treated with OADs not including secretagogues and highest among patients treated with insulin alone.
Conference/Value in Health Info
2010-11, ISPOR Europe 2010, Prague, Czech Republic
Value in Health, Vol. 13, No. 7 (November 2010)
Code
PDB73
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
Diabetes/Endocrine/Metabolic Disorders