Short-term effects of severe hypoglycaemia in children and adolescents with type 1 diabetes. A cost-of-illness study

The aim of this study was to describe costs and other short-term effects of severe hypoglycaemia in children and adolescents with type 1 diabetes. The study comprised a geographic population of 129 patients < 19 y of age with families prospectively registering detailed data after self-reported sever e hypoglycaemia. In the period Jan.-Dec. 1998, 16 events were reported with unconsciousness and 95 events without unconsciousness but needing the assi stance of another person. Of all events, 20-30% had effects requiring the a ssistance of people other than parents, school absence, parents' absence fr om work, extra transport and/or telephone calls. Patient (family) activitie s were cancelled after 10% (5%) of events. Increased worry for parents was reported after 8% and poor sleep after 7% of events. Hospital visits took p lace at 5% and hospitalizations at 3% of all events. Patients with severe h ypoglycaemia indicated lower global quality of life (p=0.0114). The average socio-economic burden for events of severe hypoglycaemia was estimated at EURO 17 400 yearly per 100 type 1 diabetes patients. Average cost was estim ated at EURO 239 per event of severe hypoglycaemia with unconsciousness or EURO 478 yearly per patient with unconscious ness, and EURO 63 per event of severe hypoglycaemia without unconsciousness but needing assistance from a nother person or EURO 307 yearly per patient in this category. These are co nservative estimates and do not include unpaid time and other intangibles, possible road traffic accidents, disabling or premature deaths. Conclusions: The results suggest the potential for socio-economic savings a nd increased quality of life for patients and families from severe hypoglyc aemia prevention programs.