Coyne, K.S.

Evripidou, P.

Kawata, A.K.

Koutsides, P.

Kulich, K.

Kyriakidou-Himonas, M.

Loizou, T.

Olympios, G.

Ong, S.H.

Pastellas, C.

Picolos, M.

Stylianou, A.

Therapontos, C.

Toufexis, C.

Wilson, H.

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A356  VA L U E  I N  H E A LT H  1 7  ( 2 0 1 4 )  A 3 2 3 – A 6 8 6  
questionnaire. Diabetes control was defined as Hb1Ac ≤ 7%. Results: The major-
ity of the sample were male (55%) and overweight (59% had BMI 25-29.9). 20.4% of 
T2DM patients had a history of laboratory-confirmed hypoglycemia. In total, 59% 
had HbA1c > 7%. The mean age was 60 and the mean T2D duration was 10 years. The 
mean QoL score of the total sample was -3.1± 1.9, the mean score of non-hypogly-
cemic patients was -3.05 ± 2.0 while the respective score of hypoglycemic patients 
was -3.26 ±1.8, (p≤ 0.005). Similar results were observed in the group of controlled 
patients and uncontrolled patients, who scored -2.73±1.7 and -3.33±1.9, respectively 
(p≤ 0.005). Comparable results were identified in the majority of the ADDQoL-19 
instruments’ dimensions. According to the logistic regression analysis the majority 
of the ADDQoL-19 dimensions were significantly affected by hypoglycemia, as well 
as by high levels of HbA1c. ConClusions: The study confirmed that the QoL of 
Greek T2D patients is negatively affected by hypoglycemic events and the level of 
the disease control. In T2D, treatment should attain good glycemic control without 
debilitating hypoglycemic episodes, which compromise patients’ QoL.
PDB138
The ImPacT Of DayTIme anD nOcTurnal nOn-Severe hyPOglycaemIc 
evenTS On PeOPle WITh DIaBeTeS In Turkey
Emral R.
Ankara University Medical Faculty, Ankara, Turkey
objeCtives: Two surveys were conducted to assess the impact of nocturnal and 
daytime hypoglycaemia on the individual and on the Turkish economy. Methods: 
People with diabetes who had experienced a non-severe hypoglycaemic event in 
the 4 weeks prior to the survey were eligible for inclusion. The surveys were con-
ducted face to face; all information, including hypoglycaemic events, was self-
reported. Results: In the Turkish cohort, 95 people responded (50 for the nocturnal 
survey [N]; 55 for the daytime survey [D]). Mean age was 49 years/48 years (N/D), 
mean weight was 76.9 kg/75.2 kg (N/D), 40%/31% (N/D) of respondents were male, 
and 64%/80% (N/D) had type 2 diabetes. Among respondents with type 2 diabetes, 
63%/48% (N/D) received insulin ± OADs and 63%/66% (N/D) received OADs ± insu-
lin. Non-severe hypoglycaemic episodes were experienced at least once/week by 
20%/35% (N/D) and at least once/month by 58%/73% (N/D) of respondents. After the 
non-severe nocturnal (N) /daytime (D) hypoglycaemic event, 16% and 9% (N/D) of 
respondents decreased their insulin dose and 16% and 20%, respectively, contacted 
a health care professional. On average, respondents used 1.5 or 1.6 (N/D) extra blood 
glucose tests the following week, and 34%/26% (N/D) of those surveyed reported a 
high level of fear of a hypoglycaemic event. Of respondents who worked for pay 
(n= 22/17), 59%/77% (N/D) reported a high/medium impact on work productivity fol-
lowing a hypoglycaemic event. Mean time to return to sleep following a nocturnal 
event was 60 minutes; 28% reported that the event had a high impact on sleep, and 
54% had difficulty focusing at work the next day. ConClusions: In Turkey, noctur-
nal and daytime non-severe hypoglycaemic events impact quality of life, utilisation 
of health care resources and productivity in people with diabetes.
PDB139
healTh relaTeD QualITy Of lIfe OuTcOmeS (hrQOl) anD reSOurce 
uSe aSSOcIaTeD WITh TyPe 2 DIaBeTeS PaTIenTS TakIng STePS TO lOSe 
WeIghT In 5 eurOPean cOunTrIeS
Nuhoho S.1, Vietri J.2, Isherwood G.3, Worbes-Cerezo M.4
1Janssen-Cilag A/S, Birkerød, Denmark, 2Kantar Health, Milan, Italy, 3Kantar Health, Epsom, UK, 
4Janssen-Cilag UK, High Wycombe, UK
objeCtives: Weight control is a cornerstone of type 2 diabetes (T2DM) management, 
but the impact of losing small to moderate amounts of weight relative to gaining 
weight on patient-reported outcomes and resource use among T2DM patients is 
not widely reported. This study was conducted to describe the association of weight 
change in T2DM patients taking steps to lose weight (TSLW) with HRQoL, work pro-
ductivity and resource use in European T2DM patients. Methods: Data came from 
the 2013 5EU National Health and Wellness Survey, representative of adults in France, 
Germany, Italy, Spain and the United Kingdom. Respondents TSLW who lost ≤ 5kg were 
compared to respondents who gained weight. Outcome measures included SF-36v2, 
Work Productivity & Activity Impairment Questionnaire, and 6-month self-reported 
health care use. Comparisons used pairwise t-tests and chi-square tests for continu-
ous and categorical variables, respectively. Results: Of 1,985 respondents taking 
steps to lose weight, 61% were male, 37% were employed with mean BMI 32.3 kg/
m2. Relative to respondents who gained weight (n= 354), respondents who lost ≤ 5kg 
(n= 560) had higher scores on mental component summary by 3.9 points (p< 0.05), 
higher physical component summary by 2.3 points (p< 0.05), and SF-6D health utility 
by 0.05 points (p< 0.05). This group reported lower work and activity impairment as 
well as lower health care resource utilisation relative to those who gained weight, with 
lower mean presenteeism (22% vs. 28%, p< 0.05), activity impairment (34% vs. 44%, 
p< 0.05), health care provider visits (7.8 vs. 10.2 p< 0.05), emergency room visits (0.2 
vs. 0.6; p< 0.05) and hospitalizations (0.2 vs. 0.4; p< 0.05). ConClusions: Treatments 
which facilitate small to moderate weight loss may offer T2DM patients better HRQoL 
and potentially offer savings to the health care system when compared to treatments 
which promote weight gain. Further research is required to explain this observation.
PDB140
racIal DISParITIeS In TyPe 2 DIaBeTeS healTh care uTIlIzaTIOn In 
meDIcaID aDulTS WITh DevelOPmenTal DISaBIlITIeS
Patel I.1, Erickson S.2, Bagozzi R.P.1, Chang J.3, Caldwell C.4, Woolford S.4, Balkrishnan R.1
1University of Michigan, Ann Arbor, MI, USA, 2The University of Michigan, Ann Arbor, MI, USA, 
3Samford University, Birmingham, AL, USA, 4University of Michigan, ANN ARBOR, MI, USA
objeCtives: Adults with developmental disabilities have higher prevalence of chronic 
disease conditions such as diabetes, obesity, high blood pressure, arthritis, CVD and 
chronic pain. They also have poor health care utilization and screened less for chronic 
disease conditions. The objective of this study was to examine the association of race, 
and medication adherence, and their interaction with health care utilization and 
health care costs in Medicaid enrollees with developmental disabilities (DD) and type 
that can guarantee good diabetes management, but its control over BMI in growing 
children is still unclear. The insulin pumps have too many advantages: reduction 
in insulin requirements, reduced variability of insulin absorption, decreased hypo-
glycemia incidents, avoided pain, improved quality of life.
PDB135
PaTIenT PreferenceS In TreaTmenT Of DIaBeTeS mellITuS: a SySTemaTIc 
revIeW Of STaTeD Preference SurveyS
Mühlbacher A.C., Kaczynski A.
Hochschule Neubrandenburg, Neubrandenburg, Germany
objeCtives: Diabetes Mellitus is one of the most expensive common diseases. 
Because of the great socio-economic importance of this indication, it seems neces-
sary to consider the expectations and needs of all patients with regard to treat-
ment characteristics. To evaluate patient preferences stated-preference methods 
are increasingly used. The aim was to analyze and compare the available evidence 
from patient preference studies regarding the treatment characteristics and to dis-
play which target criteria are most important from the patients view. Methods: A 
literature review in PubMed was conducted to identify stated preference studies in 
the indication of diabetes and show which properties of a treatment are relevant 
to the patient’s benefit. By means of level difference calculation and a subsequent 
normalization uniform weights for the attributes of the studies were determined. 
Based on a final ranking the key criteria according to their value proposition from 
the perspective of affected populations are demonstrated. Results: N= 13 studies 
could be included in the analysis. By calculating the level difference and performing 
a normalization it was possible to obtain a uniform representation of all attributes 
of each study. The analysis includes the presentation and analysis of DCE-studies 
which have illustrated the determined coefficients. The studies show that blood 
sugar control, side effects (such as hypoglycemia, nausea/stomach discomfort, 
weight changes), long-term complications (especially cardiovascular disease) and 
mode of administration represent the most patient-relevant outcomes in diabetes 
therapy. Blood glucose control achieved the highest ranking within the relative 
importance score. ConClusions: Based on the findings of this systematic review 
the evidence of patient preferences in diabetes treatment is synthesized. The results 
show the relative importance based on a derived ranking score of the used patient-
relevant endpoints. The determined ranking allows the comparison of the results of 
the identified preference studies and might solve the problem of scale heterogeneity.
PDB136
PSychOmeTrIc evaluaTIOn Of The hyPOglycaemIa PerSPecTIveS 
QueSTIOnnaIre In PaTIenTS WITh TyPe 2 DIaBeTeS mellITuS
Ong S.H.1, Kawata A.K.2, Kulich K.1, Wilson H.3, Coyne K.S.2, Evripidou P.4, Koutsides P.5, 
Kyriakidou-Himonas M.6, Loizou T.7, Olympios G.8, Pastellas C.4, Picolos M.9, Stylianou A.8, 
Toufexis C.10, Therapontos C.11
1Novartis Pharma AG, Basel, Switzerland, 2Evidera, Bethesda, MD, USA, 3Evidera, Seattle, WA, 
USA, 4Private Practice, Limassol, Cyprus, 5Limassol General Hospital, Limassol, Cyprus, 6Private 
Practice, Larnaca, Cyprus, 7Iatrodiagnosis Medical Centre, Nicosia, Cyprus, 8Larnaca General 
Hospital, Larnaca, Cyprus, 9Alithias Endocrinology Center, Nicosia, Cyprus, 10Hippocrateon 
Private Hospital, Nicosia, Cyprus, 11Novartis Pharma Services Inc., Nicosia, Cyprus
objeCtives: The Hypoglycaemia Perspectives Questionnaire (HPQ) is a patient-
reported outcomes (PRO) instrument assessing diabetic patients’ experience 
and perceptions of hypoglycaemia. The aim of this study is to evaluate the factor 
structure and psychometric characteristics of the HPQ in type 2 diabetic patients 
(T2DM). Methods: HPQ was administered to adults with T2DM in a clinical sample 
from Cyprus and a community sample in the US from 2011 US National Health and 
Wellness Survey. Demographic and clinical data were collected. Participants com-
pleted the Audit of Diabetes Dependent Quality of Life (ADDQoL-19), treatment sat-
isfaction items, and EuroQol-5 Dimensions (EQ-5D) (Cyprus only). HPQ items assess 
hypoglycaemia attitudes and behaviours on an 11-point numeric rating scale (NRS). 
Item performance and factor structure were examined and measurement properties 
(reliability, construct validity, known-groups validity) evaluated. Results: Cyprus 
(n= 500) and US (n= 1,257) T2DM samples were of similar age (Cyprus 61.0±10 years, 
US 59.9±11 years). Cyprus had more males (67.4% vs. 54.2%) and fewer obese sub-
jects (BMI ≥ 30) 45.6% vs. 67.8%) than the US. More US subjects reported hypoglycae-
mia events in the past seven days (27.7% vs. 16.6% with ≥ 1 event). Prescription oral 
diabetes medications were used by 90.3% of Cyprus participants and 83.6% of US 
participants, and insulin by 32.9% and 25.3%, respectively. Analyses supported three 
HPQ domains: Symptom Concern (six items), Compensatory Behavior (five items), 
and Worry (five items). Internal consistency was high for all three domains (all ≥ 0.75), 
supporting reliability. Convergent validity was supported by moderate correlations 
between HPQ domain scores and ADDQoL-19 total score. Patients with recent hypo-
glycaemia events had significantly higher HPQ scores supporting known-group valid-
ity. ConClusions: HPQ is a valid and reliable measure capturing the experience and 
impact of hypoglycaemia and can be useful in clinical trial and community-based 
settings.
PDB137
The Prevalence Of hyPOglycemIa anD ITS ImPacT On The QualITy Of 
lIfe Of TyPe 2 DIaBeTeS mellITuS PaTIenTS In greece (The hyPO STuDy)
Yfantopoulos J.1, Hatzikou M.2, Rombopoulos G.2, Panitti E.2, Latsou D.3
1National and Kapodistrian University of Athens, Athens, Greece, 2Novartis Hellas, Metamorfosis, 
Greece, 3University of Peloponnese, Corinth, Greece
Hypoglycemia (Hypo) is a common adverse effect of type 2 diabetes (T2D) therapy. 
Hypo has a negative impact on health care resources and quality of life (QoL) and 
can affect compliance and T2D control. objeCtives: To estimate the impact of 
Hypo on the QoL as well as its prevalence on T2D patients in Greece. Methods: A 
cross-sectional epidemiological study was conducted in 6631 patients with T2DM. 
Hypo events with different treatment regimens, T2D control rates and QoL were 
assessed. Hypo episodes were defined as laboratory-confirmed (< 70 mg/dl) symp-
tomatic events. QoL was measured using the patient-administered ADDQoL-19 


PDB136 Psychometric Evaluation of the Hypoglycaemia Perspectives Questionnaire in Patients With Type 2 Diabetes Mellitus 

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PDB136 Psychometric Evaluation of the Hypoglycaemia Perspectives Questionnaire in Patients With Type 2 Diabetes Mellitus

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