Predictors of impaired awareness of hypoglycaemia and severe hypoglycaemia in adults with type 1 diabetes
Authors' conclusion
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.
Study context
- Population
- Adults with T1D; 89% continuous glucose monitoring (CGM) users, 27% using continuous subcutaneous insulin infusion (CSII)CGM data in 402
- Participants
- 782 adults
- Outcome
- Prevalence of impaired awareness of hypoglycaemia (IAH) and severe hypoglycaemia (SH), and their risk factors
Methodological detailssurvey, severe hypoglycaemia (SH) identified based on self-reported episodes
- Survey
- SH identified based on self-reported episodes
Main finding
As reported in the abstract
Recent episode of SH (self-reported)
5.3%
Impaired awareness of hypoglycaemia (IAH) based on the Gold score
21%
Observational data: associations, not effects.
Further findings
Factors independently associated with elevated Gold score
- Socioeconomic deprivation, OR (p = 0.002)
- 1.9
- Female sex, OR (p = 0.002)
- 1.8
- Positive depression screen, OR (p = 0.007)
- 2.1
Factors independently associated with hypoglycaemia detection threshold <3.0 mM
- Older age, OR per year (p < 0.001)
- 1.03
- Positive depression screen, OR (p < 0.001)
- 2.7
Factors independently associated with SH risk
- Greater glucose variability, OR per % CV glucose (p < 0.001)
- 1.14
- Positive anxiety screen, OR (p = 0.031)
- 3.0
- Detection threshold <3.0 mM, OR (p < 0.001)
- 6.7
Original publication
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