Abstract
Objectives
The primary objective of this study was to estimate the health utility values for hypoglycaemia events according to their severity and frequency. The secondary objective was to compare the health utilities between those with Type 2 Diabetes Mellitus and the general population.
Method
The health utilities of hypoglycaemia event were measured using Visual Analogue Scale (VAS) and Time Trade-Off (TTO) methods among conveniently sampled consenting adults (>18 years and literate in either English or Malay language), which were then divided into two groups: those in the general population (GP) and those with Type 2 Diabetes Mellitus (T2DM). Each respondent was required to value 13 different health states, including frequencies of daytime hypoglycaemia and nocturnal hypoglycaemia, each depending on its severity (non-severe or severe).
Results
256 respondents from the GP and 99 respondents with T2DM completed the survey. The T2DM group gave higher VAS-values compared to the GP group. The highest mean VAS-utility value for non-severe nocturnal hypoglycaemia occurring once monthly was 0.543 (SD 0.161), and for severe daytime hypoglycaemia occurring once quarterly was 0.293 (SD 0.162) which was the lowest utility value compared to other health states. However, non-severe nocturnal hypoglycaemia occurring once quarterly was 0.537 (SD 0.284) and has the highest TTO-utility value. Severe nocturnal hypoglycaemia occurring once quarterly has the lowest utility value which was −0.104 (SD 0.380). Daytime hypoglycaemia has lower utility value compared to nocturnal hypoglycaemia. Severe hypoglycaemia has a greater disutility compared with the non-severe hypoglycaemia in both studied groups.
Conclusion
The findings show that as a health utility, hypoglycaemia has a substantial impact on utility with severe hypoglycaemia having a greater negative impact compared to non-severe events across the board. This highlights the importance of preventing development of severe hypoglycaemia in patients with Type 2 Diabetes Mellitus at any time of the day.
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Acknowledgements
We would like to thank the Director General of Health, Malaysia for his permission to publish this article and Annushiah Vasan who have helped in the mock interview and as the supervisor assessing the interviewers. Concurrently, we would like to thank Wilsom Darius, Nurfila Sharifud-Din Fatin Nabilah, Thesigan A/L Balakrishnan, Tham Shu Ni, Low Xian Wei, Nurul Ainatul Liyana Hj Mohtadzar, Ceciwani Sagathevan, Kalai Divvya A/P Ramasamy, Lee Mei Siew, Najihah Mohd Nasir, Liew Jin Sian, Looi Yi Chien, Nadia Najiha, Muhammad Arif, Nurlisya Rafiha, Low Khai Hang, Nur Adlina, Syazlin Syahira, Nuru Ain, Norfarahani, Siti Nur Najihah, Nur Adila, Sorfina, and Muhammad Hafiz from the School of Pharmaceutical Sciences, Universiti Sains Malaysia Penang who were involved in the process of completing this research.
Declaration of funding
This study was supported by an unrestricted grant from Ministry of Health Malaysia Research Grant (00794).
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Asrul A Shafie has previously provided writing assistance to Novo Nordisk. However, this study did not receive any sponsorship from Novo Nordisk. Chin Hui Ng, Subramaniam Thanimalai, Norliza Haron, and Anita Bhajan Manocha declared no conflict of interest.
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Shafie, A.A., Ng, C.H., Thanimalai, S. et al. Estimating the utility value of hypoglycaemia according to severity and frequency using the visual analogue scale (VAS) and time trade-off (TTO) survey. J Diabetes Metab Disord 17, 269–275 (2018). https://doi.org/10.1007/s40200-018-0369-z
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DOI: https://doi.org/10.1007/s40200-018-0369-z