Novo Nordisk Media Release

Four out of five people with diabetes experience hypoglycaemia

Global survey investigates the impact of hypoglycaemia on the management of Type 2 diabetes Johannesburg [Insert Date] For immediate release New data from a global survey reveals that four out of five people with Type 2 diabetes experience hypoglycaemia or low blood sugar levels, and that this affects their ability to manage the condition. 1 Hypoglycaemic events are a major challenge to effective blood sugar control for people who are living with diabetes and who are using insulin to manage it, and these have a significant impact on their quality of life. According to the GAPP2 (Global Attitudes of Patients and Physicians) survey, funded by Novo Nordisk and presented at the annual meeting of the European Association for the Study of Diabetes (EASD) this month, 36% of survey respondents had experienced an episode of hypoglycaemia in the preceding month, and 80% of those had treated the episode themselves. Despite the ability of most respondents to control these episodes without medical intervention, they nevertheless have a deep impact on the way in which they manage their condition. Nearly half (46%) of respondents reported having to increase blood glucose monitoring after a hypoglycaemic episode, and more than one in ten reported altering their long-acting insulin regime. In addition, 16% of respondents said they had intentionally not taken their insulin as prescribed in order to prevent hypoglycaemic episodes, and 14% said they had intentionally kept their blood sugar at a level higher than recommended in order to avoid hypoglycaemia during the night. Healthcare professionals also reported that their prescribing decisions were influenced by the risk of self-treated hypoglycaemia. When deciding on the type of insulin to prescribe, 82% took the risk of

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hypoglycaemia into account, and more than half (57%) started patients on a lower dose of long-acting insulin than recommended. Self-treated hypoglycaemia represents a significant clinical challenge in the management of Type 2 diabetes, says Dr Timmy Kedijang, General Manager of Novo Nordisk South Africa, because it influences both patient and prescriber behaviours as far as the use of insulin therapy is concerned. Non-adherence to insulin treatment regimens can negatively impact blood sugar control, and is also an independent predictor of mortality.2,3 Nevertheless, new data from the GAPP2 survey confirms that, whether people living with diabetes experience hypoglycaemia or not, dosing irregularities of longacting insulin remain common.4 While patients recognise the clinical consequences of this behaviour, a substantial proportion still intentionally do not take their insulin as prescribed. For example:

77% of respondents who had reduced a basal insulin dose admitted that, on the last occasion,

they had done so deliberately; 48% of respondents said they had missed a dose of basal insulin altogether; 51% said they had mistimed a basal dose by more than two hours; and 38% said they had reduced a dose of basal insulin.4

The importance of maintaining optimal glycaemic control cannot be overemphasised, as it reduces the risk of long-term complications and mortality for people living with diabetes. 5 Symptoms of a hypoglycaemic event, when blood sugar levels becomes too low, often include a rapid heartbeat, trembling, hunger, sweating, difficulty concentrating or confusion, and people living with diabetes are always urged to be alert to these symptoms.6 For further information on diabetes and treatment options for people living with the condition, visit www.novonodisk.com. References /

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References: 1. Tahrani A, Barnett AH, Brod M, Rana A, Peyrot M. GAPP2: Global survey finds three quarters of patients experience hypoglycaemia on insulin analogue causing dose irregularities and increased blood glucose monitoring. Presented at the European Association for the Study of Diabetes (EASD) October 2012 (presentation number 222)

2. Currie CJ, Peyrot M, Morgan CL, et al. The impact of treatment noncompliance on mortality in
people with Type 2 diabetes. Diabetes Care 2012;35:1279-1284

3. Donnelly LA, Morris AD, Evans JMM. Adherence to insulin and its association with glycaemic
control in patients with Type 2 diabetes. QJ Med 2007;100:345-350

4.

Brod M, Peyrot M, Rana A, Barnett AH. GAPP2: Global survey finds one in eight patients

intentionally reduce basal insulin doses to avoid hypoglycaemia. Presented at the European Association for the Study of Diabetes (EASD) October 2012. (presentation number 995) 5. Donnelly LA, Morris AD, Frier BM, et al. Frequency and predictors of hypoglycaemia in Type 1 and insulin-treated Type 2 diabetes: a population-based study. Diabetic Med 2005;22:749-755

6. Brod M, Christensen T, Thomsen TL, Bushnell DM. The impact of non-severe hypoglycaemic
events on work productivity and diabetes management. Value Health 2011;14:665-671

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