Hypoglycaemia focus in diabetes rethink

A psychology researcher at Victoria’s Deakin University has joined an international project pushing for a rethink on how diabetes is treated, with an aim to address hypoglycaemia.

The four-year, $42 million Hypo-Resolve project brings together researchers, clinicians, industry and those living with diabetes to increase understanding of the causes and impact of hypoglycaemia, and identify better solutions to prevent and manage it. The news coincides with National Diabetes Week in Australia (July 7-14).

Professor Jane Speight, Foundation Director of the Australian Centre for Behavioural Research in Diabetes at Deakin’s School of Psychology, says hypoglycaemia is a serious issue for people with diabetes.

“Severe hypoglycaemia can lead to collapse without warning, impacts on memory and thinking, cardiovascular disease and, in rare cases, even sudden death,” she said.

But despite the serious effects of ‘hypos’, Professor Speight says current approaches to managing diabetes are more focused on preventing long-term complications, such as blindness or amputation, than these acute complications.

Professor Speight is co-leading the psychology work stream of Hypo-Resolve (one of eight streams), focusing on the psychological impact of hypoglycaemia, working alongside Professor Frans Pouwer from the University of Southern Denmark.

“At the moment, the average blood glucose level – HbA1c – is often considered the most important outcome in the majority of diabetes clinical trials,” she said. “But reducing HbA1c is often achieved at the expense of an increase in hypoglycaemia.

“We’ve seen many impressive new treatments in the past 30 years, but unfortunately rates of hypoglycaemia have largely stayed the same. That’s partly because there’s not been a universally agreed definition of hypoglycaemia, or how it should be measured, and partly because the impact of hypoglycaemia has not been fully recognised.”

Professor Speight says the condition can be a scary experience, affecting the ability to drive, travel alone and look after children.

“Just one severe event can lead people to become fearful about having more, and it can severely restrict their independence and what they are able to do,” she said.

“It also affects how people manage their diabetes. They might decide to keep their blood glucose levels higher as a result, to avoid hypos, but that’s not an advisable long-term strategy, because high glucose levels can lead to other complications, like kidney damage, amputation and blindness.”