Hypoglycaemia Assessment Tool (HAT) study: subanalysis of the Lebanese cohort

Authors: Mireille Amm, Mohamad Rawas, Zelia Francis, Maya Chehabeddine, Amal Chalfoun, Mazen El Akel and Marie Merheb

Background: Diabetic hypoglycaemia affects medication adherence, patients’ productivity and quality of life. It is also associated with an increased risk of cardiovascular complications.
Aims: To examine the impact of hypoglycaemia in insulin-treated patients in the Lebanese cohort of the Hypoglycaemia Assessment Tool (HAT) study.

Methods: The HAT study was an observational study covering a 6-month retrospective and a 4-week prospective period in 24 countries including Lebanon. Data were collected using self-assessment questionnaires and patient diaries from 1158 Lebanese patients, aged ≥ 18 years, with type 1 or type 2 diabetes mellitus (T1DM/T2DM) treated with insulin for > 12 months. The primary endpoint was the proportion of patients experiencing ≥ 1 hypoglycaemic event during the 4-week follow-up period.

Results: After 4 weeks of follow-up, 177/225 [78.7%; 95% confidence interval (CI): 72.7–83.8] of patients with T1DM and 291/630 (46.2%; 95% CI: 42.2–50.2) patients with T2D experienced at least 1 hypoglycaemic event. Rates of nocturnal and severe hypoglycaemia were 10.7 (95% CI: 9.1–12.3) and 13.2 (95% CI: 11.5–14.9) events/patient-year for T1DM, and 3.3 (95% CI: 2.8–3.8) and 4.2 events/patient-year (95% CI: 3.6–4.8) for T2DM, respectively. Fear of hypoglycaemia was significantly associated with nocturnal and severe hypoglycaemia in both diabetes types (P < 0.001).

Conclusion: The results suggest that the less-advanced healthcare systems in Lebanon are implicated in lower levels of patient knowledge about hypoglycaemia and related preventive measures. Treatment strategies and glycaemia goals should be individualized according to patient preference, medical benefits, and risk of hypoglycaemia.

Received: 17/05/18; accepted: 24/04/19

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