Non-severe nocturnal hypoglycemic events: experience and impacts on patient functioning and well-being

Qual Life Res. 2013 Jun;22(5):997-1004. doi: 10.1007/s11136-012-0234-3. Epub 2012 Jul 24.


Purpose: Non-severe nocturnal hypoglycemic events (NSNHEs) are hypoglycemic events that occur during sleep but do not require medical assistance from another individual. This study was conducted to better understand the NSNHEs as patients actually experience them in their daily life, and how they impacted functioning and well-being.

Methods: Nine focus groups were held in four countries with diabetics (Type 1 and Type 2) who had experienced an NSNHE within the previous month: France (2 groups); Germany (2 groups); United Kingdom (2 groups); and United States (3 groups). These groups were audio-taped, translated to English where applicable, and analyzed thematically.

Results: Seventy-eight people with diabetes participated in the focus groups: 41 (53 %) were female and 37 (47 %) were male; 24 (31 %) had Type 1 diabetes, and 54 (69 %) had Type 2 diabetes. Participant reports were grouped into several major themes: next day effects, symptoms, sleep impacts, social impacts, corrective action, practical management, feelings about NSNHEs, and work impacts.

Conclusions: People with both Type 1 and Type 2 diabetes experience NSNHEs. The range of impact on these patients is wide, from very mild to severe with a majority of participants experiencing strong impacts that limit their daily functioning. This finding suggests that NSNHEs are more impactful than previously believed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Adult
  • Aged
  • Circadian Rhythm
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetes Mellitus, Type 1 / therapy
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diabetes Mellitus, Type 2 / therapy
  • Disease Management
  • Female
  • Focus Groups
  • France / epidemiology
  • Germany / epidemiology
  • Health Status*
  • Humans
  • Hypoglycemia / physiopathology*
  • Hypoglycemic Agents / administration & dosage
  • Interviews as Topic
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Personal Satisfaction
  • Qualitative Research
  • Quality of Life*
  • Severity of Illness Index
  • Sickness Impact Profile*
  • Sleep
  • United Kingdom / epidemiology
  • United States / epidemiology


  • Hypoglycemic Agents