New Data Show Post-Meal Hyperglycaemia is Associated with a Negative Impact on Quality of Life for People with Diabetes

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Nov 01, 2016, 04:00 ET

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Abstract: 69477

New data from the first health-related quality of life (HRQL) study related to post-meal or postprandial glucose (PPG) control, show that poor PPG control has a significant negative impact on quality of life for people with diabetes^[1]. Findings will be presented today at the 19^th Annual European Congress of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) in Vienna, Austria.

The study sought to evaluate the perceived impact of postprandial hyperglycaemia on people with type 1 and type 2 diabetes. Three health state descriptions characterising postprandial hyperglycaemia symptoms of varying frequency and severity (mild, moderate and severe) were evaluated using a Time Trade-Off (TTO)^[*] approach by members of the general public in the UK and people with diabetes in Sweden^[1].

Findings showed the following mean health state utility values, where 0 indicates death and 1 indicates full health: TTO 0.89 and 0.76 for the mild state, TTO 0.75 and 0.71 for the moderate state and TTO 0.56 and 0.58 for the severe state, among the UK general public and Swedish people with type 1 and type 2 diabetes respectively^[1].

"Good metabolic control cannot solely be indicated by the percentage of patients reaching their glycaemic targets measured as HbA_1c. Also the glucose excursions and the degree of postprandial hyperglycaemia need to be addressed," said Professor Johan Jendle, Örebro University of Sweden and scientific secretary for the Swedish Society of Diabetology. "Postprandial glucose control is important for the quality of life of people with both type 1 and type 2 diabetes."

Overall, the study indicates that increasing severity in postprandial hyperglycaemic symptoms is perceived to have significant negative consequences for the short-term HRQL of people with diabetes^[1].

About the study^[1]

The aim of this analysis was to quantify the impact of PPG control on HRQL of people with diabetes, expressed as health utilities using a TTO approach.

In the first stage of the study, an initial literature review was conducted, followed by interviews with people with diabetes, clinicians and nurses, to characterise the nature of impact of postprandial hyperglycaemic symptoms of varying severity and frequency. Based on these findings, three health state descriptions were drafted with mild, moderate and severe symptoms of postprandial hyperglycaemia.

For the valuation part of the study, a total of 300 people, including 150 members of the UK general public and 150 Swedish people with type 1 and type 2 diabetes, were recruited to take part in a face-to-face TTO interview, a standard technique used to determine a utility value for each of the three health states. Participants were asked to choose between living in the health state for a 10-year time frame or living in full health for a reduced amount of time.

The study was funded by Novo Nordisk A/S.

About postprandial glucose (PPG) control

Post-meal or postprandial, glucose (PPG) is the level of blood glucose concentration measured 1-2 hours after eating. When PPG levels rise too high after eating, it is known as post-meal, or postprandial, hyperglycaemia. Postprandial hyperglycaemia is associated with increased risk of cardiovascular disease, cancer, damage to eyes, impaired cognitive function (in people with type 2 diabetes) among other diabetes-related complications^[2],[3]. The longer time spent in a hyperglycaemic state, the worse overall blood glucose control.

Achieving tight PPG control is important to achieve optimal blood glucose control, HbA_1c targets^[4], and to reduce risk of short-term and long-term complications associated with hyperglycaemia^[5].

About Novo Nordisk

Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. This heritage has given us experience and capabilities that also enable us to help people defeat other serious chronic conditions: haemophilia, growth disorders and obesity. Headquartered in Denmark, Novo Nordisk employs approximately 42,600 people in 75 countries and markets its products in more than 180 countries. For more information, visit novonordisk.com, Facebook, Twitter, LinkedIn, YouTube

*A TTO approach was used to provide a utility value for each state. Participants were asked to choose between living in a selected health state for a 10-year time frame or living in full health for a reduced amount of time.

References

Sandberg A, et al. Improvements in health-related quality of life associated with increased control of postprandial glucose levels in diabetes. Research supported by Novo Nordisk. Poster presentation at the ISPOR 19^th Annual European Congress. 29 October-2 November 2016; Vienna, Austria.
IDF 2011 Guideline for Management of Post Meal Glucose. Available at: http://www.idf.org. Last accessed: October 2016.
Madsbad S. Impact of postprandial glucose control on diabetes-related complications: How is the evidence evolving? Journal of Diabetes and its Complications 2016; 30(2):374-385.
Monnier L, et al. Is postprandial glucose a neglected cardiovascular risk factor in type 2 diabetes? European Journal of Clinical Investigation 2000; 30(Suppl. 2):3-11.
Ceriello A, et al. Guideline for management of postmeal glucose. Nutrition, Metabolism and Cardiovascular Disease 2008; 18:S17-S33.