Severe hypoglycemia, impaired awareness of hypoglycemia, and self-monitoring in adults with type 1 diabetes: Results from Diabetes MILES-Australia

TY - JOUR

T1 - Severe hypoglycemia, impaired awareness of hypoglycemia, and self-monitoring in adults with type 1 diabetes

T2 - Results from Diabetes MILES-Australia

AU - Hendrieckx, Crystal

AU - Jenkins, A

AU - Hagger, Virginia

AU - Skinner, Timothy Charles

AU - Pouwer, Frans

AU - Speight, Jane

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Aims To assess prevalence of severe hypoglycemia, awareness and symptoms of hypoglycemia, and their associations with self-monitoring of blood glucose. Methods Diabetes MILES—Australia Study participants completed validated questionnaires and study-specific items. Results Of 642 adults with type 1 diabetes, 21% reported ≥ 1 severe hypoglycemic event in the past six months, and 21% reported impaired awareness of hypoglycemia (IAH). Severe hypoglycemia was increased four-fold for those with IAH compared with intact awareness (1.4 ± 3.9 versus 0.3 ± 1.0). Of those with IAH, 92% perceived autonomic and 88% neuroglycopenic symptoms, albeit at lower glucose thresholds compared to people with intact awareness. Those with IAH were more likely to perceive both symptom types at the same glucose level or to perceive neuroglycopenic symptoms first (all p < 0.001). Eighteen percent with IAH treated hypoglycemia only when they perceived symptoms and another 18% only when their capillary glucose was < 3.0 mmol/L. Conclusions One in five adults with type 1 diabetes had IAH or experienced severe hypoglycemia in the past six months. Total loss of hypoglycemia symptoms was rare; most people with IAH retained autonomic symptoms, perceived at relatively low glucose levels. Frequent self-monitoring of blood glucose prompted early recognition and treatment of hypoglycemia, suggesting severe hypoglycemia risk can be minimized.

AB - Aims To assess prevalence of severe hypoglycemia, awareness and symptoms of hypoglycemia, and their associations with self-monitoring of blood glucose. Methods Diabetes MILES—Australia Study participants completed validated questionnaires and study-specific items. Results Of 642 adults with type 1 diabetes, 21% reported ≥ 1 severe hypoglycemic event in the past six months, and 21% reported impaired awareness of hypoglycemia (IAH). Severe hypoglycemia was increased four-fold for those with IAH compared with intact awareness (1.4 ± 3.9 versus 0.3 ± 1.0). Of those with IAH, 92% perceived autonomic and 88% neuroglycopenic symptoms, albeit at lower glucose thresholds compared to people with intact awareness. Those with IAH were more likely to perceive both symptom types at the same glucose level or to perceive neuroglycopenic symptoms first (all p < 0.001). Eighteen percent with IAH treated hypoglycemia only when they perceived symptoms and another 18% only when their capillary glucose was < 3.0 mmol/L. Conclusions One in five adults with type 1 diabetes had IAH or experienced severe hypoglycemia in the past six months. Total loss of hypoglycemia symptoms was rare; most people with IAH retained autonomic symptoms, perceived at relatively low glucose levels. Frequent self-monitoring of blood glucose prompted early recognition and treatment of hypoglycemia, suggesting severe hypoglycemia risk can be minimized.

U2 - 10.1016/j.jdiacomp.2016.11.013

DO - 10.1016/j.jdiacomp.2016.11.013

M3 - Journal article

C2 - 27993524

SN - 1056-8727

VL - 31

SP - 577

EP - 582

JO - Journal of Diabetes and its Complications

JF - Journal of Diabetes and its Complications

IS - 3

ER -