RESEARCH ARTICLE


Hypoglycemia among Insulin-treated Patients with Diabetes: Egypt Cohort of IO HAT Study



Mohamed Hesham Mohamed Fahmy El Hefnawy1, Talaat Abd el Fattah Abdelaaty2, Atef Abdelmoniem Bassyouni3, Hesham Magdeldin Saleem4, Mohsen Mostafa Mussa Khalid5, Dalia Nabil Toaima6, *, Mohamed Ahmed Gaber Maree7
1 National Institute of Diabetes, Cairo, Egypt
2 Faculty of Medicine, Alexandria University, Chamblion st, El Azareeta, Alexandria, Egypt
3 Department of Internal Medicine, National Institute of Diabetes and Endocrinology, Cairo 11017, Egypt
4 Cairo University Egypt, 9 Al Gameya, Oula, Giza Governorate, Egypt
5 National Institute of Diabetes and Endocrinology, 220 A El-Gazayer st, New Maadi, Cairo, Egypt
6 Medical Department, Novo Nordisk Egypt, 47th building, North 90 st, Fifth settlement, Cairo 11835, Egypt
7 Novo Nordisk Egypt, 47th building, North 90 st, Fifth settlement, New Cairo, Cairo, Egypt


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© 2018 El Hefnawy et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Medical Department, Novo Nordisk Egypt, 47th building, North 90 street, Fifth settlement, Cairo 11835, Egypt; Tel: +201028220905; E-mail; dlto@novonordisk.com


Abstract

Objectives:

The study aims to assess the real-world incidence of hypoglycemia in patients with Type 1 Diabetes Mellitus (T1DM) or Type 2 Diabetes Mellitus (T2DM) in Egypt cohort of the International Operations Hypoglycemia Assessment Tool (IO HAT) study.

Methods:

This is a non-interventional study to estimate hypoglycemia in eligible patients with T1DM or T2DM, aged ≥18 years and treated with insulin for >12 months, who have completed self-assessment questionnaires to record demography, treatment information, and hypoglycemia during the 6-month/4-week retrospective and 4-week prospective periods. Data on hypoglycemia for this sub-analysis were collected from DM patients of Egyptian cohort who were recruited in IO HAT study across 36 sites in Egypt between 22 Nov 2014 and 15 Apr 2015.

Results:

Percentage of patients who reported at least one hypoglycemic event in the prospective period was any: T1DM: 96.3% (95% confidence interval [CI]: 89.6%, 99.2%) and T2DM: 93.1% (95% CI: 89.8%, 95.6%) and severe: T1DM: 67.5% (95% CI: 56.1%, 77.6%) and T2DM: 64.2% (95% CI: 58.7%, 69.4%). An estimated rate of any and severe hypoglycemia in the prospective period was 63.3 (95% CI: 57.2, 69.9) events per patient year (PPY) and 28.9 (95% CI: 24.8, 33.4) events PPY, respectively, for patients with T1DM and 32.0 (95% CI: 29.8, 34.3) events PPY and 15.5 (95% CI: 14.0, 17.1) events PPY, respectively, for patients with T2DM. Hypoglycemic rate was independent of glycated hemoglobin levels.

Conclusion:

The self-reported hypoglycemia data from Egypt confirms that hypoglycemia is under-reported. The high impact of hypoglycemia on the Egyptian DM patients and healthcare system warrants patient education to prevent hypoglycemia.

Keywords: Hypoglycemia, Insulin, Diabetes Mellitus, International Operations Hypoglycemia Assessment Tool, Egypt, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus.