A real‐life comparison of hypoglycaemia symptomatology between insulin‐treated type 2 diabetes participants with and without impaired awareness of hypoglycaemia
Authors' conclusion
Gold and Clarke questionnaires are appropriate tools in ascertaining IAH status in insulin-treated type 2 diabetes participants. This is the first time whereby the hypoglycaemia symptomology has robustly validated the Gold and Clarke questionnaire in insulin-treated type 2 diabetes participants.
Study context
- Population
- Insulin-treated T2D participants attending an outpatient diabetes clinic in Singapore; mean age 61.0 ± 9.4 years, diabetes duration 19.5 ± 8.8 years, HbA1c 68 ± 17 mmol/mol (8.4 ± 1.5%)M:F = 98:55
- Participants
- 153 participants
- Exposure
- Intact awareness vs impaired awareness of hypoglycaemia (IAH), classified by Gold and Clarke questionnaires
- Outcome
- Hypoglycaemic symptomatic responses (with capillary blood glucose and symptoms recorded), compared with Gold and Clarke questionnaire scores
- Follow-up
- 4 weeks
Methodological detailsreal-life, single outpatient diabetes clinic
- Real-life
- Single outpatient diabetes clinic
Main finding
As reported in the abstract
Autonomic symptoms at capillary blood glucose (CBG) <3 mmol/L, Gold classification
P = 0.006
Observational data: associations, not effects.
Further findings
Autonomic symptoms at CBG <3 mmol/L, Clarke classification · greater with intact awareness
P = 0.010
- No hypoglycaemia symptoms · greater proportion with IAH
- Gold: p = 0.015; Clarke: p = 0.031
- Severe hypoglycaemia in the preceding year · higher with IAH
- Clarke: p = 0.012
- Severe hypoglycaemia in the preceding year — Gold: IAH vs intact awareness
- 17% vs. 3.3%
- Severe hypoglycaemia in the preceding year — Clarke: IAH vs intact awareness
- 15% vs. 2.7%
No hypoglycaemia symptoms
- Significantly greater proportion of participants with IAH experienced no hypoglycaemia symptoms than those with intact awareness, by Gold and Clarke
Participants classified with IAH
- Gold
- 19.6%
- Clarke
- 26.8%
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
A real‐life comparison of hypoglycaemia symptomatology between insulin‐treated type 2 diabetes participants with and without impaired awareness of hypoglycaemia. Diabet Med. Published 4 September 2023. doi:10.
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