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06-06-2022 | ADA 2022 | Conference coverage | News

Women most often have psychosocial consequences of hypoglycemia

Author: Eleanor McDermid

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medwireNews: Women are more likely than men to experience repercussions of serious or severe hypoglycemia that impact their wellbeing or diabetes management, a study suggests.

The findings from the BETTER registry, based in Quebec, Canada, found that women were more likely than men to experience important anxiety and persistent fatigue after an episode of severe hypoglycemia (requiring third-party assistance or use of glucagon). Approximately 40% of women reported this outcome.

These associations persisted after accounting for factors including fear of hypoglycemia and hypoglycemia confidence, reported Meryem Talbo (McGill University, Montreal, Quebec) in the late-breaking poster session at the 82nd ADA Scientific Sessions in New Orleans, Louisiana.

The study was based on the questionnaire responses of 590 women and 310 men. Women were significantly more likely than men to be using an insulin pump (49 vs 37%) and equally likely to be using intermittently scanned (52%) or real-time (32%) continuous glucose monitoring.

An identical proportion of women and men had experienced severe hypoglycemia within the past year (15%), but more women than men had experienced serious hypoglycemia (<54 mg/dL or 3.0 mmol/L without need for assistance) within the past month (84 vs 76%). They were also more likely to report symptomatic nocturnal hypoglycemia within the past month (71 vs 62%).

Women had significantly lower hypoglycemia confidence than men, more frequently had an elevated fear of hypoglycemia (61 vs 43%), and more frequently had psychosocial and/or diabetes management consequences following the most recent hypoglycemia episode, for both severe (95 vs 87%) and serious (78 vs 70%) episodes.

For both sexes, the most common effects of hypoglycemia on diabetes management were more frequent blood glucose measurements, changes in insulin doses, and consuming more carbohydrate and/or keeping a source to hand at all times. The most frequent psychosocial consequences were anxiety and fatigue, and, in the case of severe episodes, embarrassment or shame.

For serious episodes, women were significantly more likely than men to have persistent fatigue and to report consequences for their daily lives, and this persisted on multivariable analysis. In the univariable analysis, they were also more likely to have anxiety, loss of productivity, and to skip insulin injections, although this was infrequently reported overall. Men were more likely than women to have obtained a glucagon prescription after a serious episode.

“Social constructs on stress management may explain the observed gender differences and suggest taking a gender-based differential approach when addressing hypoglycemia,” conclude the researchers.

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group

ADA Scientific Sessions; New Orleans, Louisiana: 3–7 June 2022


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