Hypoglycemia frequency and treatment satisfaction in patients receiving insulin analogues for treatment of type 1 diabetes mellitus

ABSTRACT Objective: The aim of this study was to evaluate the frequency of hypoglycemia and the treatment satisfaction in patients with type 1 diabetes (T1D) using insulin analogues. Subjects and methods: This observational retrospective study included 516 adult patients with T1D from 38 cities in Southern Brazil. Demographics and clinical data were collected using a self-report questionnaire. Hypoglycemia was defined as an event based on either symptoms or self-monitored blood glucose < 70 mg/dL. Treatment satisfaction was evaluated using the Diabetes Treatment Satisfaction Questionnaire status version (DTSQs) and with a specific question with scores ranging from 0-10. Common mental disorders were assessed using the General Health Questionnaire (GHQ-12). Results: Overall, the mean age was 38 ± 14 years and 52% of the participants were women. The median diabetes duration was 18 years. The scores for insulin analogue treatment satisfaction were higher than those for previous treatments. DTSQ scores had a median value of 32 (interquartile range 29-35) and remained unchanged over time. The percentage of patients with hypoglycemia (including severe and nocturnal) was comparable across groups divided according to duration of use of insulin analogues. Most patients (n=395, 77%) screened positive for common mental disorders. Conclusions: Patient satisfaction with insulin analogue treatment was high and remained unchanged with time. Episodes of hypoglycemia also remained unchanged over time among patients using insulin analogues.

Validation to Brazilian Portuguese of the Self-Care Inventory-revised for adults with type 2 diabetes

ABSTRACT Objective The aim of this study was to cross-culturally adapt and validate the Brazilian Portuguese version of SCI-R to adults with type 2 diabetes. Materials and methods The SCI-R is a 15-question survey that reflects how well patients with diabetes have adhered to treatment recommendations. A pretest (n = 40) was first performed to improve comprehension of the survey items. A final version was then self-administered in another 75 adults with type 2 diabetes to determine the survey's reliability and validity according to its association with HbA1c. Finally, we conducted a test-retest reliability analysis over three weeks to stabilize the sample and determine intra-observer variability. Results After the pretest phase, the final sample's (N = 75) mean age was 59.9 ± 7.5 years and mean HbA1c level was 8.6 ± 1.5% (70 ± 16.4 mmol/mol). The initial Cronbach's alpha was 0.61; however, further analysis showed that four items had low item correlation and were excluded from the final version, which increased the Cronbach's alpha to 0.63. In predictive validity analysis, HbA1c levels correlated significantly with total survey scores (r = -0.38, P = 0.001). The intra-class correlation coefficient between baseline and three-week scores was 0.93, which indicates high reproducibility. Conclusions The Brazilian Portuguese version of the SCI-R is a valid tool for measuring treatment adherence in adults with type 2 diabetes.