Dr. Roberta Bondar shares personal anecdotes of time alone in the dark in space to drive awareness of nighttime hypoglycemia
TORONTO, Nov. 15, 2017 /CNW/ - Diabetes is one of the most challenging health problems in the 21st century. The number of people with the condition is increasing in every country worldwide, and Canada is no exception with 3.5 million people (or nearly one out of every three) living with diabetes.1 Nocturnal, or nighttime, hypoglycemia (low blood glucose levels) is a hidden problem within the diabetes community. Together, Novo Nordisk and Diabetes Canada are creating important conversations to shed light on the emotional, physical and financial impact of nighttime hypoglycemia.
Many people with diabetes experience nighttime hypoglycemic events several times a month, yet research has shown they are often underreported and may go unrecognized.2 Typical symptoms of mild hypoglycemia include dizziness, hunger/thirst, shaking and sweating; more severe events can cause confusion, disorientation, coma and death.3
Research also shows that hypoglycemia causes more absenteeism from work, more impairment while at work (presenteeism) and decreased overall work productivity compared with patients who have never experienced the condition.4 Worse still, the frequency of hypoglycemia increases with age but awareness of the condition actually decreases the longer a patient has diabetes as symptoms may become progressively less intense.5 In turn, this unawareness has been linked to a six-fold increased risk of severe hypoglycemia in people with type 2 diabetes.6
People with type 1 and type 2 diabetes who use insulin as part of their treatment plan are exposed to the risk of hypoglycemia.7 While members of the diabetes community are increasingly engaged in their care and therapy options in an effort to live free from diabetes-related complications, improved conversations about hypoglycemic events – whether day or night – between those living with diabetes and their healthcare professional are essential.
When the amount of blood glucose or sugar in your blood has dropped below an individual's target range (less than four mmol/L), it is called low blood glucose or hypoglycemia.8 Hypoglycemia is the most common adverse effect associated with intensive insulin therapy.9 The severity of hypoglycemia varies from confusion and numbness to coma and seizures, requiring the support of another individual.10 The incidence of severe hypoglycemia in the Canadian population with diabetes is estimated to be 1.9 and 2.6 episodes per patient per year in patients with type 1 and 2 diabetes, respectively, while the incidence of non-severe hypoglycemia is estimated to be 102 and 66 episodes per patient per year. Moreover, the incidence of severe hypoglycemia reported during sleep is estimated to be 0.5 and 0.2 episodes per patient per year in patients with type 1 and 2 diabetes, respectively.11
About The World Awake report
A research based report summarizing the findings of The World Awake survey conducted amongst over 1,000 adults globally with Type 1 diabetes (536 respondents) or Type 2 diabetes (571 respondents). This report evaluates the impact of self-treated nocturnal hypos and the worry that they cause on the lives of people with diabetes who are insulin-treated. The report includes recommendations for improving awareness of and encouraging dialogue around nocturnal hypos between people with diabetes and their healthcare professionals. To learn more about The World Awake report, visit www.worldawake.info.
Dr. Jan Hux, Chief Science Officer, Diabetes Canada
"Diabetes Month is an opportune time to shine light on diabetes and to address the often hidden problems associated with it, like nocturnal hypoglycemia that impose severe impacts on people affected by diabetes and an unmeasured burden on healthcare resources. At Diabetes Canada, we strive to help people lead healthy lives with diabetes through education and by creating healthier environments at a community and at a policy level."
Dr. Harpeet Bajaj, Endocrinologist, LMC Diabetes & Endocrinology and Research Associate, Mount Sinai Hospital, Toronto
"Hypoglycemia can take many forms ranging from mild and moderate to severe requiring immediate medical attention. Hypoglycemia in all forms has significant impact on a patient's physical health, as well as their mental health, financial wellbeing and work productivity. Greater awareness and discussion of hypoglycemia is critical to improve diabetes care in Canada."
Brian Hilberdink, President, Novo Nordisk Canada Inc.
"World Awake is a key component of Novo Nordisk's commitment to address issues relating to effective diabetes care. The results of our global World Awake study suggest a major education gap in the area of nocturnal hypoglycemia. More must be done to improve the dialogue between people with diabetes and healthcare professionals regarding this serious obstacle to treatment satisfaction and wellbeing of our patients."
Charlene Lavergne, person living with type 2 diabetes
"As someone who has lived with diabetes for more than 40 years, I regularly experence nighttime hypoglycemia. Each episode leaves me feeling disoriented and afraid. I am sharing my experiences openly to let other Canadians living with this disease know that they are not alone in their stuggles with nightime hypoglycemia."
Renira Narrandes, person living with type 1 diabetes
"I was diagnosed with type 1 diabetes a month into starting my master's of occupational therapy program. The first year was very difficult; I was hospitalized a few times as my body struggled to adjust. Nine years later, I manage pretty well, although there is never a break from diabetes. When I wake up, as I'm walking to work, sitting in meetings or at the gym—I always need to pay attention to my blood sugar level. It can drop quickly depending on what I'm doing—or even what I did a few hours ago."
1 Diabetes Canada. Diabetes Charter for Canada: Diabetes in Canada. https://www.diabetes.ca/getmedia/513a0f6c-b1c9-4e56-a77c-6a492bf7350f/diabetes-charter-backgrounder-national-english.pdf.aspx. Accessed November 2017.
2 International Diabetes Federation & Novo Nordisk. The World Awake: A global research report uncovering the impact of nocturnal hypoglycaemia on people with diabetes. http://www.worldawake.info/content/dam/Worldawak/AFFILIATE/www-worldawake-info/Home/Documents/World-Awake_report_Jan-2017.pdf. Accessed November 2017.
3 Hamdy O, Srinivasan VAR, Snow KJ. Hypoglycemia Clinical Presentation. Medscape Reference. Available at http://emedicine.medscape.com/article/122122-clinical. Accessed November 2017.
4 Lopez, J.M., Annunziata, K., et al. Impact of hypoglycemia on patients with type 2 diabetes mellitus and their quality of life, work productivity, and medication adherence. Patient Prefer Adherence. 2014 May 8;8:683-92.
5 Kalra, S., Mukherjee J. J., Venkataraman S., et al. Hypoglycemia: The neglected complication. Indian J Endocrinol Metab. 2013 Sep-Oct; 17(5).
6 Kalra S., Mukherjee J. J., Venkataraman S., et al. Hypoglycemia: The neglected complicationIndian J Endocrinol Metab. 2013 Sep-Oct; 17(5).
7 International Diabetes Federation & Novo Nordisk. The World Awake: A global research report uncovering the impact of nocturnal hypoglycaemia on people with diabetes. http://www.worldawake.info/content/dam/Worldawak/AFFILIATE/www-worldawake-info/Home/Documents/World-Awake_report_Jan-2017.pdf. Accessed November 2017.
8 Diabetes Canada. Low's & Highs: Blood Sugar Levels. Available at http://www.diabetes.ca/diabetes-and-you/healthy-living-resources/blood-glucose-insulin/lows-highs-blood-sugar-levels. Accessed: November 2017
9 Leiter LA, et al. Assessment of the Impact of Fear of Hypoglycemic Episodes on Glycemic and Hypoglycemia Management. Canadian Journal Diabetes 2005;29(3):186–192.
10 Clayton, D., et al. Clinical Practice Guidelines: Hypoglycemia. Canadian Journal of Diabetes. 37 (2013) S69eS71. http://www.canadianjournalofdiabetes.com/article/S1499-2671(13)00023-3/pdf. Accessed November 2017.
11 Harris, S., Mamdani, M., Galbo-Jørgensen, C. B., Bøgelund, M., Gundgaard, J., & Groleau, D. (2014). The effect of hypoglycemia on health-related quality of life: Canadian results from a multinational time trade-off survey. Canadian journal of diabetes, 38(1), 45-52.
SOURCE Novo Nordisk Canada Inc.