Ingvild Hernar, Ragnhild B Strandberg, Roy M Nilsen, John G Cooper, Timothy C Skinner, Marjolein M Iversen, David A Richards, Silje S Lie, Karianne F Løvaas, Tone Vonheim Madsen, Grethe Å Ueland, Anne Haugstvedt
{"title":"低血糖意识减退的发生率和风险因素：对挪威 10,202 名 1 型糖尿病成人进行的登记研究。","authors":"Ingvild Hernar, Ragnhild B Strandberg, Roy M Nilsen, John G Cooper, Timothy C Skinner, Marjolein M Iversen, David A Richards, Silje S Lie, Karianne F Løvaas, Tone Vonheim Madsen, Grethe Å Ueland, Anne Haugstvedt","doi":"10.1111/dme.15480","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study is to determine the prevalence of impaired awareness of hypoglycaemia (IAH) and examine risk factors for IAH in adults with type 1 diabetes.</p><p><strong>Methods: </strong>We conducted a population-based registry study of 10,202 adults (≥18 years) with type 1 diabetes using data from the Norwegian Diabetes Register for Adults. The registry used the 1-item Gold scale, measuring hypoglycaemia symptom awareness. We calculated the overall prevalence of IAH (Gold score ≥4) (95% CI) and prevalence for subgroups based on demographic and clinical variables. We estimated IAH prevalence based on continuous scales of age, diabetes duration and HbA<sub>1c</sub> using predicted probabilities from generalised additive logistic regression models. Finally, we quantified the associations of selected variables on IAH prevalence using log-binomial regression models.</p><p><strong>Results: </strong>Overall, 18.0% reported IAH (95% CI 17.2, 18.7). The prevalence increased linearly with the participants' age, whereas the associations of diabetes duration and HbA<sub>1c</sub> with IAH were non-linear with higher prevalence in both lower and higher tails of their distributions. Multiple severe hypoglycaemic events, female sex, age ≥ 65 years, diabetes duration ≤4 years or ≥ 30 years, multiple DKA events and CGM use were associated with higher risk for IAH. HbA<sub>1c</sub> 65-74 mmol/mol (8.1-8.9%) was associated with lower risk for IAH.</p><p><strong>Conclusions: </strong>In this nationwide study, the IAH prevalence was 18.0%. Multiple hypoglycaemic events, female sex and diabetes duration were identified as important risk factors for IAH. Study findings highlight the complexity of self-reported hypoglycaemia symptom awareness and emphasise the importance of routinely addressing symptom awareness in diabetes follow-up.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15480"},"PeriodicalIF":3.2000,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevalence and risk factors for impaired awareness of hypoglycaemia: A registry-based study of 10,202 adults with type 1 diabetes in Norway.\",\"authors\":\"Ingvild Hernar, Ragnhild B Strandberg, Roy M Nilsen, John G Cooper, Timothy C Skinner, Marjolein M Iversen, David A Richards, Silje S Lie, Karianne F Løvaas, Tone Vonheim Madsen, Grethe Å Ueland, Anne Haugstvedt\",\"doi\":\"10.1111/dme.15480\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>The aim of this study is to determine the prevalence of impaired awareness of hypoglycaemia (IAH) and examine risk factors for IAH in adults with type 1 diabetes.</p><p><strong>Methods: </strong>We conducted a population-based registry study of 10,202 adults (≥18 years) with type 1 diabetes using data from the Norwegian Diabetes Register for Adults. The registry used the 1-item Gold scale, measuring hypoglycaemia symptom awareness. We calculated the overall prevalence of IAH (Gold score ≥4) (95% CI) and prevalence for subgroups based on demographic and clinical variables. We estimated IAH prevalence based on continuous scales of age, diabetes duration and HbA<sub>1c</sub> using predicted probabilities from generalised additive logistic regression models. Finally, we quantified the associations of selected variables on IAH prevalence using log-binomial regression models.</p><p><strong>Results: </strong>Overall, 18.0% reported IAH (95% CI 17.2, 18.7). The prevalence increased linearly with the participants' age, whereas the associations of diabetes duration and HbA<sub>1c</sub> with IAH were non-linear with higher prevalence in both lower and higher tails of their distributions. Multiple severe hypoglycaemic events, female sex, age ≥ 65 years, diabetes duration ≤4 years or ≥ 30 years, multiple DKA events and CGM use were associated with higher risk for IAH. HbA<sub>1c</sub> 65-74 mmol/mol (8.1-8.9%) was associated with lower risk for IAH.</p><p><strong>Conclusions: </strong>In this nationwide study, the IAH prevalence was 18.0%. Multiple hypoglycaemic events, female sex and diabetes duration were identified as important risk factors for IAH. Study findings highlight the complexity of self-reported hypoglycaemia symptom awareness and emphasise the importance of routinely addressing symptom awareness in diabetes follow-up.</p>\",\"PeriodicalId\":11251,\"journal\":{\"name\":\"Diabetic Medicine\",\"volume\":\" \",\"pages\":\"e15480\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-11-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetic Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/dme.15480\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetic Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/dme.15480","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Prevalence and risk factors for impaired awareness of hypoglycaemia: A registry-based study of 10,202 adults with type 1 diabetes in Norway.
Aims: The aim of this study is to determine the prevalence of impaired awareness of hypoglycaemia (IAH) and examine risk factors for IAH in adults with type 1 diabetes.
Methods: We conducted a population-based registry study of 10,202 adults (≥18 years) with type 1 diabetes using data from the Norwegian Diabetes Register for Adults. The registry used the 1-item Gold scale, measuring hypoglycaemia symptom awareness. We calculated the overall prevalence of IAH (Gold score ≥4) (95% CI) and prevalence for subgroups based on demographic and clinical variables. We estimated IAH prevalence based on continuous scales of age, diabetes duration and HbA1c using predicted probabilities from generalised additive logistic regression models. Finally, we quantified the associations of selected variables on IAH prevalence using log-binomial regression models.
Results: Overall, 18.0% reported IAH (95% CI 17.2, 18.7). The prevalence increased linearly with the participants' age, whereas the associations of diabetes duration and HbA1c with IAH were non-linear with higher prevalence in both lower and higher tails of their distributions. Multiple severe hypoglycaemic events, female sex, age ≥ 65 years, diabetes duration ≤4 years or ≥ 30 years, multiple DKA events and CGM use were associated with higher risk for IAH. HbA1c 65-74 mmol/mol (8.1-8.9%) was associated with lower risk for IAH.
Conclusions: In this nationwide study, the IAH prevalence was 18.0%. Multiple hypoglycaemic events, female sex and diabetes duration were identified as important risk factors for IAH. Study findings highlight the complexity of self-reported hypoglycaemia symptom awareness and emphasise the importance of routinely addressing symptom awareness in diabetes follow-up.
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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