Effects of continuous glucose monitor-recorded nocturnal hypoglycaemia on quality of life and mood during daily life in type 1 diabetes

Aims/hypothesis The aim of this work was to assess the effect of spontaneous nocturnal hypoglycaemia on quality of life and mood during subsequent days in type 1 diabetes. Methods A total of 153 people with type 1 diabetes participated in 6 days of blinded continuous glucose monitoring while documenting hypoglycaemic symptoms, quality of life and mood, daily. Hypoglycaemia was defined by interstitial glucose <= 3.9 mmol/l (IG(3.9)) and <= 3.0 mmol/l (IG(3.0)) for >= 15 min and was classified as asymptomatic if no hypoglycaemic symptoms were reported. Results Self-estimated quality of life assessed by the EQ-5D VAS (but not by the WHO Well-Being Index) was higher the day after asymptomatic (but not after symptomatic) hypoglycaemic nights, as compared with non-hypoglycaemic nights (IG(3.9), p = 0.021; IG(3.0), p = 0.048). The effect increased with lower glucose nadir and longer duration of nocturnal hypoglycaemia (IG(3.9), p = 0.03). The finding was confined to participants with impaired hypoglycaemia awareness. There was no effect of nocturnal hypoglycaemia on mood or self-estimated effectiveness at work the following day. Conclusions/interpretation Individuals with type 1 diabetes and impaired hypoglycaemia awareness reported higher quality of life on days preceded by nights with asymptomatic (but not symptomatic) hypoglycaemia. The effect was amplified by lower glucose nadir and longer duration of the episodes and may help explain resistance to implementation of interventions to reduce hypoglycaemia in many people with impaired hypoglycaemia awareness.

Automated summary

Individuals with type 1 diabetes and impaired hypoglycaemia awareness tend to report higher quality of life on days following asymptomatic (but not symptomatic) hypoglycaemic nights. The effect is amplified by lower glucose nadir and longer duration of the episodes, while there is no significant impact observed on mood and work effectiveness the following day after nocturnal hypoglycaemia.