| Abstract | Uvod: Šećerna bolest je kronična i kompleksna bolest u kojoj uspjeh kontroliranja u velikoj mjeri ovisi o mogućnosti pacijenta u pridržavanju terapije i modifikacije životnog stila. Pacijentovo znanje o hipoglikemiji stoga bitno doprinose boljoj kontroli bolesti. Glavni cilj istraživanja bio je istražiti prevalenciju, znanje i stavove o hipoglikemiji među ispitanicima sa šećernom bolesti.
Ispitanici i metode: Ukupno 553 pacijenta sa šećernom bolesti (srednje dobi od 63,1 godina, oba spola podjednako zastupljena), s trajanjem bolesti od najmanje dvije godine su uključeni u istraživanje. Svi uključeni ispitanici su liječeni u Regionalnom centru za dijabetes, endokrinologiju i bolesti metabolizma Kliničkog bolničkog centra Split, te su ispunili upitnik koji je ispitao njihovo znanje i stavove o dijabetesu i hipoglikemiji.
Rezultati: Prosječna HbA1C vrijednost u ispitivano populaciji je bila 7,95%, s prosječnim trajanjem bolesti od 13,4 godine. Većina pacijenata je imala šećernu bolest tipa 2 (N=466, 84,2%), 11,8% pacijenata (N=65) je imala šećernu bolest tipa 1, dok su ostale oblike šećerne bolesti imali 4,0% pacijenata (N=22). Približno polovina pacijenata je bila na terapiji oralnim hipoglikemicima (N=244, 44,1%), 35% (N=198) na inzulinskoj terapiji, a 17% (N=94) je primalo kombinaciju inzulina i oralnih hipoglikemijskih lijekova. Većina pacijenata (57%, N=315) je iskusilo najmanje jednu epizodu hipoglikemije, dok je 29,2% (N=92) ispitanika imalo epizodu hipoglikemije koja je zahtijevala pomoć druge osobe i to je bilo uglavnom povezano s inzulinskom monoterapijom. Polovina pacijenata (N=280, 50,6%) dobila je informacije o hipoglikemiji od svog liječnika, 16,1% (N=89) od svoje obitelji, 11,2% (N=62) iz različitih časopisa, a 13,4% (N=74) pacijenata nisu znali ništa o hipoglikemiji. Najčešći simptomi hipoglikemije bili su slabost (N=117), drhtanje ruku (N=110) i hladni znoj (N=107), te polovini pacijenata (N=159) nije bilo pravila u vremenu nastanka hipoglikemije. Manje od jedne trećine (N=174, 31,5%) ispitanika imalo je odgovarajuće znanje o uporabi glukagona u slučaju teške hipoglikemije. Pacijenti koji su doživjeli hipoglikemiju imali su znatno bolje znanje o glukagonu od pacijenata koji nisu imali hipoglikemiju (N=154, 48,9% naprema N=20, 8,4%, P<0,001). Glukagon je upotrijebilo barem jednom 5,2% (N=29) ispitanika.
Zaključak: Pronađena je visoka prevalencija hipoglikemije među ispitivanom populacijom, a razina znanja o hipoglikemiji i uporabi glukagona nije bila zadovoljavajuća. S obzirom na rizike povezane s hipoglikemijom, treba naglasiti važnost preventivnih mjera i daljnjih obrazovnih programa za poboljšanje pružanja zdravstvene skrbi i samoupravljanja bolesnika s šećernom bolesti. |
| Abstract (english) | Introduction: Diabetes mellitus (DM) is a chronic and complex disease and the success of DM management largely depends upon a patient’s self-ability to comply with medication regimen and lifestyle modifications. Patient education and knowledge about hypoglycemia is therefore important in contribution to the patient’s awareness and better control of the disease. The main goal of the study was to explore prevalence, knowledge and attitudes about hypoglycemia among enrolled diabetic patients.
Subjects and methods: A total of 553 diabetic patients (mean age 63.1±14.3 years, both gender equally represented) with a duration of the disease of at least 2 years were consecutively enrolled. All the included patients were treated at the Diabetes Center at University Hospital of Split (Split, Croatia), and have completed a questionnaire that assessed their knowledge and attitudes regarding diabetes and hypoglycemia.
Results: The average HbA1c value in the studied population was 7.95% with the average duration of disease of 13.4 years. Most patients had type 2 DM (N=466, 84.2%), 11.8% patients (N=65) had type 1 DM while other types of diabetes comprised 4.0% (N=22). Nearly half of the patients were on oral hypoglycemic therapy (N=244, 44.1%), 35% (N=198) on insulin therapy, and 17% (N=94) received combination of insulin and oral hypoglycemic agents. The majority of patients (57%, N=315) experienced at least one episode of hypoglycemia while 29.2% (N=92) of patients had a hypoglycemic episode that required a help from another person and this was highly associated with insulin monotherapy. Half of the patients (N=280, 50.6%) received information about hypoglycemia from their doctor, 16.1% (N=89) from their family, 11.2% (N=62) from various magazines, while 13.4% (N=74) of patients reported not having any knowledge about hypoglycemia. Most frequent hypoglycemia symptoms were weakness (N=117), tremulousness (N=110) and cold sweat (N=107), and there was not any order in hypoglycemia occurrence time in half of the patients (N=159). Less than one-third (N=174, 31.5%) of patients had an adequate knowledge about emergent glucagon kit usage in case of severe hypoglycemia. Group which experienced hypoglycemia had significantly better knowledge about glucagon use than group that hadn’t had hypoglycemia (N=154, 48.9% vs. N=20, 8.4%; P<0.001).
Conclusion: We found a high prevalence of hypoglycemia among the examined population, and the level of knowledge about hypoglycemia and the usage of glucagon were unsatisfactory. Considering the risk associated with hypoglycemia, preventive measures and further educational programs must be emphasized for improvement of health care delivery and self-management of diabetic patients. |
