Predictors of impaired awareness of hypoglycaemia and severe hypoglycaemia in adults with type 1 diabetes

IF 3.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2025-05-19 DOI:10.1111/dme.70074

Nicola N. Zammitt, Shareen Forbes, Berit Inkster, Mark W. J. Strachan, Rohana J. Wright, Anna R. Dover, Roland H. Stimson, Fraser W. Gibb

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Abstract

Aims

This study aimed to assess the prevalence of impaired awareness of hypoglycaemia (IAH) and severe hypoglycaemia (SH) in adults with type 1 diabetes and identify risk factors for both conditions in a contemporary cohort.

Methods

A cross-sectional survey was conducted on 782 adults with type 1 diabetes. Participants completed a questionnaire including validated hypoglycaemia awareness and mental health tools. Continuous glucose monitoring (CGM) data were collected in 402 participants. SH was identified based on self-reported episodes.

Results

89% were CGM users and 27% were using continuous subcutaneous insulin infusion (CSII). 5.3% of participants reported a recent episode of SH and 21% had IAH based on the Gold score. Elevated Gold Score was independently associated with socioeconomic deprivation (OR 1.9, p = 0.002), female sex (OR 1.8, p = 0.002) and positive depression screen (OR 2.1, p = 0.007). Hypoglycaemia detection threshold <3.0 mM was independently associated with older age (OR 1.03 per year, p < 0.001) and positive depression screen (OR 2.7, p < 0.001). Greater glucose variability (OR 1.14 per % CV glucose, p < 0.001), positive anxiety screen (OR 3.0, p = 0.031) and detection threshold <3.0 mM (OR 6.7, p < 0.001) were all independently associated with SH risk.

Conclusions

The prevalence of SH is lower in the modern era of type 1 diabetes management and may reflect greater use of CGM and CSII. Mental health symptoms and socioeconomic deprivation are key associations with IAH and SH. Risk models incorporating clinical, psychological and CGM data may more effectively predict SH.

Abstract Image

查看原文本刊更多论文

成人1型糖尿病患者低血糖和严重低血糖意识受损的预测因素

目的：本研究旨在评估成人1型糖尿病患者对低血糖（IAH）和严重低血糖（SH）认知受损的患病率，并确定当代队列中这两种情况的危险因素。方法：对782例成人1型糖尿病患者进行横断面调查。参与者完成了一份调查问卷，包括有效的低血糖意识和心理健康工具。收集了402名参与者的连续血糖监测（CGM）数据。SH是根据自我报告的发作来确定的。结果：89%的患者使用CGM， 27%使用持续皮下胰岛素输注（CSII）。根据金牌评分，5.3%的参与者报告最近有过SH发作，21%的参与者有IAH。Gold Score升高与社会经济剥夺（OR 1.9, p = 0.002）、女性性别（OR 1.8, p = 0.002）和阳性抑郁筛查（OR 2.1, p = 0.007）独立相关。结论：在现代1型糖尿病管理中，SH的患病率较低，可能反映了CGM和CSII的更多使用。心理健康症状和社会经济剥夺是IAH和SH的主要关联因素。纳入临床、心理和CGM数据的风险模型可能更有效地预测SH。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

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.”