'There is more to life than HbA1c': A comprehensive qualitative framework from the Hypo-RESOLVE project evidencing the impacts of hypoglycaemia on the quality of life of adults living with type 1 or type 2 diabetes

Aims To develop a comprehensive, in-depth understanding of the impacts of hypoglycaemia on the quality of life of adults living with type 1 (T1D) or type 2 diabetes (T2D).Methods Thirty-one adults with T1D or T2D who experienced hypoglycaemia participated in semi-structured interviews. Participants were purposively sampled by age, sex and type/duration of diabetes. Informed by a health-related quality of life (HRQoL) framework and literature review, an interview guide explored hypoglycaemia-related impacts on quality of life. Interviews were audio-recorded, transcribed verbatim and analysed using Framework Analysis.Results Impacts were coded within three overall themes (physical, psychological and social) comprising 38 subthemes. Of the 11 physical subthemes, the most discussed were sleep, physiological symptoms, leisure and exercise, eating and drinking. Of the 18 psychological subthemes, the most discussed included: awareness; cognitive burden and planning; self management and coping; worry and anxiety; autonomy, independence and control. Of the nine social subthemes, the most discussed were impacts on others and relationship with partner.Conclusions A novel HRQoL framework highlights a comprehensive range of impacts of hypoglycaemia on physical, psychological and social functioning of people living with diabetes. These findings offer insights for clinicians, researchers and other interested parties seeking to benefit person-centred outcomes, such as quality of life.