Frequency of symptomatic and asymptomatic hypoglycaemia in Type 1 diabetes: effect of impaired awareness of hypoglycaemia

Schopman, J.E.; Geddes, Jacqueline; Frier, Brian M.

doi:10.1111/j.1464-5491.2010.03203.x

Cited by 35 publications

(29 citation statements)

References 15 publications

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“…The study of Östenson et al (2014) reported that respondents with impaired awareness had significantly higher nonsevere hypoglycemic event rates than those who were aware. A number of previous studies have shown a statistically significant increase in severe hypoglycemic events in patients with reduced awareness (Nazar et al, 2016; Weitgasser & Lopes, 2015; Schopman, Geddes & Frier, 2011; Choudhary et al, 2010; Smith et al, 2009; Geddes et al, 2008). Kulzer, Seitz & Kern (2014) found a significant correlation between awareness of hypoglycemia and asymptomatic, nonsevere hypoglycemic events.…”

Section: Discussionmentioning

confidence: 98%

“…This same literature also refers to impaired awareness of hypoglycemia in people with type 2 diabetes (Banck-Petersen et al, 2007; Clarke et al, 1995) which can increase the risk of severe hypoglycemia (Moghissi, Ismail-Beigi & Devine, 2013). A number of previous studies have shown a statistically significant increase in severe hypoglycemic events in patients with reduced awareness (Weitgasser & Lopes, 2015; Schopman, Geddes & Frier, 2011; Choudhary et al, 2010; Smith et al, 2009; Geddes et al, 2008; Clarke et al, 1995). The study by Rondags et al (2015) showed that hypoglycemia awareness significantly reduces severe hypoglycemia episodes.…”

Section: Introductionmentioning

confidence: 98%

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Self-reported frequency, severity of, and awareness of hypoglycemia in type 2 diabetes patients in Turkey

Besen

Sürücü

Koşar

2016

PeerJ

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ObjectivesHypoglycemia is a common side effect of insulin therapy in type 1 and type 2 diabetes. Limited data exist on the frequency of hypoglycemic events in type 2 diabetic patients in Turkey. Our study investigated self-reported hypoglycemic events and awareness of hypoglycemia in Turkish patients with type 2 diabetes.MethodsPeople with type 2 diabetes older than 18 years of age were recruited from the two university hospital diabetes clinics. The frequency and severity of hypoglycemia and awareness of hypoglycemia during the preceding year were determinated using questionnaires by the face-to-face interview method.ResultsIn this study of 187 patients with type 2 diabetes, 83.4% had impaired awareness of their hypoglycemia, and 62% reported that they had missed some of the symptoms of hypoglycemia. Of the patients reporting hypoglycemic symptoms and severity level, 84.1% experienced mild hypoglycemia, 60% moderate, and 15.5% severe hypoglycemia in the past year. No significant association was made between hypoglycemia awareness and age, body-mass index (BMI), years of diabetes, dose of insulin, duration of insulin use, number of meals, or amount of snacking. A significant correlation was found between A1c levels and hypoglycemia awareness and severity of hypoglycemia. A significant correlation was found between dose of insulin, amount of snacking, and severity of hypoglycemia. No significant association was made between severity of hypoglycemia and age, BMI, years of diabetes, duration of insulin use, or the number of meals. However, the group with severe hypoglycemia had diabetes longer, and the average daily dose of insulin use was higher than in other groups.ConclusionsAccording to the study results, the percentage of patients with impaired awareness of hypoglycemia is high, and 62% of patients reported that they had missed some of the symptoms of hypoglycemia in type 2 diabetes. In addition, the percentage of severe hypoglycemic events is not low. Impaired awareness of hypoglycemia is a major risk factor for severe hypoglycemic events. Patients should be educated about the danger of hypoglycemia. Education should be improved, and a determined attempt should be made to eradicate the problem.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 98%

Self-reported frequency, severity of, and awareness of hypoglycemia in type 2 diabetes patients in Turkey

Besen

Sürücü

Koşar

2016

PeerJ

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“…Further, assessment of alcohol use and hypoglycemia-related WCB such as skipping meals is encouraged since they are known to be associated with hypoglycemia. 15 , 18 …”

Section: Discussionmentioning

confidence: 99%

The Relationship of Worry About Hypoglycemia With Diabetes-specific and Typical Youth Behavior Among Emerging Adults With Type 1 Diabetes

et al. 2014

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Purpose Little is known about the relationship of worry about hypoglycemia with diabetes-specific and typical-youth behaviors among emerging adults with type 1 diabetes. This study’s purpose was to examine the relationship among worry about hypoglycemia, diabetes management, and glycemic control within the context of alcohol use, hypoglycemia-related weight control behaviors, depressive symptoms, and impulse control among emerging adults with type 1 diabetes. Research Design and Methods The sample was 181 emerging adults with type 1 diabetes who were part of a larger study. Path analysis was used to test associations among worry about hypoglycemia, diabetes management, hypoglycemia-related weight control behaviors (WCB), alcohol use, impulse control, depressive symptoms and glycemic control. Results Path model fit and modification indices suggested that a feedback loop between worry about hypoglycemia and diabetes management should be incorporated into the original model. Youth with fewer depressive symptoms reported fewer hypoglycemia-related WCB and less worry about hypoglycemia; those with higher impulse control had less alcohol use and better diabetes management; those with lower alcohol use had more worry about hypoglycemia; and better glycemic control was associated with better diabetes management. Conclusions Health care professionals need to understand how multiple factors related to worry about hypoglycemia and diabetes management interact in emerging adults. In the context of depressive symptoms, impulse control, alcohol use, and hypoglycemia-related WCB, the path model results suggest several potential avenues for intervening to improve glycemic control in emerging adults.

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“…126 All aimed to foster improved symptom recognition and self-treatment practices and all were predicated on data showing that impaired hypoglycaemia awareness could be induced/reversed by hypoglycaemia exposure/avoidance [127][128][129][130][131][132] and increased the risk of severe hypoglycaemia sixfold. 133 Although all had led to some improvements, none had resulted in full restoration of awareness or obliteration of severe hypoglycaemia. Our curriculum built on the reported interventions tested in these studies but included psychological strategies to identify and address the specific unhelpful cognitions maintaining impaired hypoglycaemia awareness informed by our own qualitative research.…”

mentioning

confidence: 99%

Improving management of type 1 diabetes in the UK: the Dose Adjustment For Normal Eating (DAFNE) programme as a research test-bed. A mixed-method analysis of the barriers to and facilitators of successful diabetes self-management, a health economic analysis, a cluster randomised controlled trial of different models of delivery of an educational intervention and the potential of insulin pumps and additional educator input to improve outcomes

Heller

Lawton

Amiel

et al. 2014

Programme Grants for Applied Research

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Improving management of type 1 diabetes in the UK: the Dose Adjustment For Normal Eating (DAFNE) programme as a research test-bed. A mixed-method analysis of the barriers to and facilitators of successful diabetes self-management, a health economic analysis, a cluster randomised controlled trial of different models of delivery of an educational intervention and the potential of insulin pumps and additional educator input to improve outcomes

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Frequency of symptomatic and asymptomatic hypoglycaemia in Type 1 diabetes: effect of impaired awareness of hypoglycaemia

Abstract: Adults with Type 1 diabetes who have impaired awareness of hypoglycaemia are exposed to a much higher incidence of asymptomatic hypoglycaemia than those with normal awareness and are at higher risk of developing severe hypoglycaemia.

Cited by 35 publications

References 15 publications

Self-reported frequency, severity of, and awareness of hypoglycemia in type 2 diabetes patients in Turkey

Self-reported frequency, severity of, and awareness of hypoglycemia in type 2 diabetes patients in Turkey

The Relationship of Worry About Hypoglycemia With Diabetes-specific and Typical Youth Behavior Among Emerging Adults With Type 1 Diabetes

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