Evaluating the impact of severe hypoglycaemia definition wording on severe hypoglycaemia history assessment.

IF 3.2 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Yu Kuei Lin, Wen Ye, Emily Hepworth, Lynn Ang, Stephanie A Amiel, Simon J Fisher
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Abstract

Aim: Several wordings of the definition of severe hypoglycaemia (SH) exist. This study aims to evaluate how different SH definition wordings affect SH history assessment.

Methods: In this cross-sectional study, surveys were emailed to registrants of the T1D Exchange, a U.S. national type 1 diabetes patient registry. Participants' demographic information was collected. Six-month SH history was evaluated with questionnaires including SH definition wordings from either (1) professional societies, (2) a diabetes community website, or (3) a hypoglycaemia research questionnaire. Analyses included the McNemar test, pairwise Wilcoxon signed-rank test, logistic regression analysis, Kappa statistics, and Spearman correlation.

Results: A total of 1580 valid responses were obtained from participants (52% female; mean ± SD age: 46 ± 15 years; 95% White; mean ± SD diabetes duration: 25 ± 16 years). Questionnaires with four different SH definition wordings yielded significant variations in the prevalence of SH (i.e., having developed at least one episode of SH) and the number of SH episodes: the ADA/ENDO 2013 definition wording yielded the highest results on both metrics, whereas HypoA-Q and ADA 2023 yielded the lowest. Among participants reporting at least one SH episode, the number of episodes identified with the different SH definition wordings was poorly correlated (Rs: 0.09-0.37; p < 0.001). Race, education level, and household income were associated with higher odds of discrepancies in SH history (p < 0.05).

Conclusion: This U.S. national survey with individuals living with type 1 diabetes demonstrated significant discrepancies in SH history when assessed with different SH definition wordings. Race and socioeconomic status were associated with these discrepancies.

评估严重低血糖定义措辞对严重低血糖史评估的影响。
目的:严重低血糖(SH)的定义有几种说法。本研究旨在评估不同的SH定义词如何影响SH历史评估。方法:在这项横断面研究中,调查通过电子邮件发送给T1D Exchange(美国国家1型糖尿病患者登记处)的注册人。收集了参与者的人口统计信息。6个月的SH病史通过问卷进行评估,问卷包括来自(1)专业学会、(2)糖尿病社区网站或(3)低血糖研究问卷的SH定义。分析包括McNemar检验、两两Wilcoxon sign -rank检验、logistic回归分析、Kappa统计和Spearman相关。结果:共获得1580份有效问卷(52%为女性;平均年龄:46±15岁;95%的白人;平均±SD糖尿病病程:25±16年)。四种不同SH定义措辞的问卷在SH患病率(即至少发生过一次SH发作)和SH发作次数方面存在显著差异:ADA/ENDO 2013定义措辞在这两个指标上都产生了最高的结果,而HypoA-Q和ADA 2023产生了最低的结果。在报告至少一次SH发作的参与者中,用不同SH定义词确定的发作次数相关性不强(Rs: 0.09-0.37;p结论:这项针对1型糖尿病患者的美国全国调查显示,当使用不同的SH定义措辞评估时,他们的SH病史存在显著差异。种族和社会经济地位与这些差异有关。
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来源期刊
Diabetic Medicine
Diabetic Medicine 医学-内分泌学与代谢
CiteScore
7.20
自引率
5.70%
发文量
229
审稿时长
3-6 weeks
期刊介绍: Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”
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