Usefulness of the Hypoglycemia awareness questionnaire in characterizing the Hypoglycemia events, proactive behaviors, and healthcare services used in patients with type 2 diabetes treated with insulin

Objective: Hypoglycemia is a serious complication of type 2 diabetes (DM2), but its severity and incidence and the healthcare services used are usually underreported in clinical practice. We aimed to describe the severity and frequency of hypoglycemia episodes, the proactive behaviors adopted, and healthcare services used by administering the Hypoglycemia Awareness Questionnaire (HypoA-Q). Methods: In this cross-sectional, multicenter, validation study, demographic data and clinical variables were retrieved from electronic records, and the HypoA-Q questionnaire was filled out. Questions 1 and 2 assessed the frequency of hypoglycemia events and the healthcare services used. Questions 4c, 4d, 9, 16b, and 16c evaluated the proactive behaviors of the patient and/or caregiver during the occurrence of hypoglycemic events. Results: In total, 502 DM2 patients treated with insulin and with a history of hypoglycemia were included in this study [54.6% women, median age: 65 years (interquartile range: 58–73); 55.4% receiving the basal-bolus regimen]. 281 (56%) patients reported at least one hypoglycemic event in the last year; 25% reported at least one severe hypoglycemia event; and 8.7% required hospitalization. Only 52% of patients monitored their capillary blood glucose levels to assess for hypoglycemia. Conclusion: The use of HypoA-Q questionnaire in usual clinical practice could facilitate the characterization of hypoglycemia events and the identification of at-risk populations by healthcare professionals and payers.