Facilitated conversations can reduce family hypoglycemia burden in diabetes
An international survey of more than 4,300 family members of people with diabetes suggests that most feel worried or anxious about their loved one experiencing a hypoglycemic episode, with three-quarters of respondents reporting they spent time helping family members manage low blood glucose events, according to findings published in Diabetes Therapy.
“There has been little research undertaken on the wider significance of low blood sugar to the family members of people living with diabetes,” Stewart B. Harris MD, MPH, FCFP, FACPM, professor at the Schulich School of Medicine and Dentistry at the University of Western Ontario, Canada, and a research scientist at the Lawson Health Research Institute, said in a press release. “Something as simple as having an open and honest conversation may be incredibly beneficial. This survey suggests that family members may help inspire more conversations about low blood sugar within the family, as well as with health care providers.”
In a cross-sectional study, Harris and colleagues analyzed data from 4,300 family members of people with type 1 or type 2 diabetes who were prescribed insulin or other diabetes medications for at least 12 months (37% parents; 18% spouses/partners; median respondent age, 46.6 years; 48% men). Respondents completed a 47-item online questionnaire between April and May 2019 via Ipsos Healthcare. Researchers designed the TALK-HYPO questionnaire to capture background information on the respondent and relative with diabetes, participant-reported data on experiences of hypoglycemia-specific burden and the impact of conversations on diabetes management. An information page within the questionnaire provided descriptions of daytime mild/moderate hypoglycemic events, severe daytime hypoglycemic events and nocturnal hypoglycemic events.
Survey results revealed that 63% of people with diabetes experienced at least monthly mild to moderate daytime hypoglycemic episodes, and 26% experienced severe daytime hypoglycemia, whereas 30% experienced nocturnal hypoglycemia (mild, moderate or severe). Approximately one-third of people with diabetes were hospitalized for hypoglycemia in the previous 12 months, respondents reported.
The results from the TALK-HYPO survey suggest that up to 64% of family members of people living with either type 1 or type 2 diabetes report feeling worried or anxious about the risk of their loved one experiencing low blood sugar, highlighting the impact of low blood sugar on the whole family. Additionally, 74% of respondents reported that because they spent time helping family members manage hypoglycemic events, they spent less time on other activities, and 76% of those surveyed believe that conversations about low blood sugar would be helpful.
Researchers found that only 34% of respondents felt they had regular conversations about hypoglycemia, defined as about once a week or more often, with their relative living with diabetes. The most common barriers to conversations about hypoglycemia were the person with diabetes not wanting to talk about it (43%), the person with diabetes living too far away (37%), a lack of confidence or knowledge (33%), and a feeling that it was not the respondent’s role (32%).
“This survey of family members of people with diabetes details the significant burden on many of them that result[s] from helping to manage their [relative’s] hypoglycemia,” the researchers wrote. “Strategic collaboration through conversations between health care providers and family members of people with diabetes could reduce the burden and risk of hypoglycemia, providing new evidence of the importance of engaging family members in diabetes management.”
To further explore the patient-caregiver experience, Novo Nordisk conducted a series of filmed experiments, where people living with diabetes and their family members shared their personal thoughts and feelings about hypoglycemia. The videos are available at www.talkhypos.com, according to the company. The website also provides recommendations for patients on starting conversations about hypoglycemia within the family and with health care providers. – by Regina Schaffer
Disclosures: Novo Nordisk funded this study. Ratzki-Leewing reports she has received research grant support from Sanofi and consultant fees from Novo Nordisk. Please see the study for all other authors’ relevant financial disclosures.