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- Title
Associations of fear of hypoglycemia with second-line use of insulin secretagogues or insulin and subsequent glycemic control in patients with type 2 diabetes: An analysis using data from the DISCOVER study.
- Authors
Wang, Jun‐Sing; Chen, Hungta; Tang, Fengming; Sheu, Wayne Huey‐Herng; Wang, Jun-Sing; Sheu, Wayne Huey-Herng
- Abstract
<bold>Background: </bold>Associations of fear of hypoglycemia with prescription of second-line insulin secretagogues (IS) or insulin and subsequent glycemic control in patients with type 2 diabetes were analysed using data from the DISCOVER study-a large, prospective, observational study.<bold>Methods: </bold>Patients with type 2 diabetes initiating a second-line treatment after a first-line oral therapy were enrolled. Fear of hypoglycemia was assessed using baseline Hypoglycemia Fear Survey (HFS) worry score. Glycemic control was assessed using glycated haemoglobin (HbA1c) levels at 6-month and 1-year follow-up, and HbA1c change from baseline was analysed. To examine the association of baseline HFS worry scores with second-line use of IS or insulin, a hierarchical logistic model with country as random effect was used.<bold>Results: </bold>A total of 6217 patients were analysed. The mean HFS worry score was 6.9 ± 11.4, while patients in the upper quartile had an HFS worry score ≥9. We divided patients into three groups according to their baseline HFS worry score (0, 1-8, ≥9). HFS worry score was associated with the use of first-line IS, but not the second-line treatment. Compared to treatments with no IS and insulin, a better HbA1c response to second-line IS or insulin was noted in patients with a baseline HFS worry score of 0 or 1-8, but not in patients with a baseline HFS worry score ≥9.<bold>Conclusion: </bold>HFS worry score was associated with the use of first-line IS and glycemic response to second-line IS or insulin in patients with type 2 diabetes.<bold>Trial Registration: </bold>ClinicalTrials.gov NCT02322762. Registered 23 December 2014.
- Publication
International Journal of Clinical Practice, 2020, Vol 74, Issue 6, p1
- ISSN
1368-5031
- Publication type
journal article
- DOI
10.1111/ijcp.13485