Severe hypoglycemia, impaired awareness of hypoglycemia, and self-monitoring in adults with type 1 diabetes

Results from Diabetes MILES-Australia

Christel Hendrieckx, Virginia Hagger, Alicia Jenkins, Timothy Chas Skinner, Frans Pouwer, Jane Speight

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Aims: To assess prevalence of severe hypoglycemia, awareness and symptoms of hypoglycemia, and their associations with self-monitoring of blood glucose. 

    Methods: Diabetes MILES-Australia Study participants completed validated questionnaires and study-specific items. 

    Results: Of 642 adults with type 1 diabetes, 21% reported ≥. 1 severe hypoglycemic event in the past six months, and 21% reported impaired awareness of hypoglycemia (IAH). Severe hypoglycemia was increased four-fold for those with IAH compared with intact awareness (1.4. ±. 3.9 versus 0.3. ±. 1.0). Of those with IAH, 92% perceived autonomic and 88% neuroglycopenic symptoms, albeit at lower glucose thresholds compared to people with intact awareness. Those with IAH were more likely to perceive both symptom types at the same glucose level or to perceive neuroglycopenic symptoms first (all p. <. 0.001). Eighteen percent with IAH treated hypoglycemia only when they perceived symptoms and another 18% only when their capillary glucose was <. 3.0. mmol/L. 

    Conclusions: One in five adults with type 1 diabetes had IAH or experienced severe hypoglycemia in the past six. months. Total loss of hypoglycemia symptoms was rare; most people with IAH retained autonomic symptoms, perceived at relatively low glucose levels. Frequent self-monitoring of blood glucose prompted early recognition and treatment of hypoglycemia, suggesting severe hypoglycemia risk can be minimized.

    Original languageEnglish
    Pages (from-to)577-582
    Number of pages6
    JournalJournal of Diabetes and Its Complications
    Volume31
    Issue number3
    Early online date27 Nov 2016
    DOIs
    Publication statusPublished - 2017

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    Type 1 Diabetes Mellitus
    Hypoglycemia
    Blood Glucose Self-Monitoring
    Glucose
    Hypoglycemic Agents

    Cite this

    Hendrieckx, Christel ; Hagger, Virginia ; Jenkins, Alicia ; Skinner, Timothy Chas ; Pouwer, Frans ; Speight, Jane. / Severe hypoglycemia, impaired awareness of hypoglycemia, and self-monitoring in adults with type 1 diabetes : Results from Diabetes MILES-Australia. In: Journal of Diabetes and Its Complications. 2017 ; Vol. 31, No. 3. pp. 577-582.
    @article{f91aafaa05aa4d2294064fdfa9bb32fe,
    title = "Severe hypoglycemia, impaired awareness of hypoglycemia, and self-monitoring in adults with type 1 diabetes: Results from Diabetes MILES-Australia",
    abstract = "Aims: To assess prevalence of severe hypoglycemia, awareness and symptoms of hypoglycemia, and their associations with self-monitoring of blood glucose. Methods: Diabetes MILES-Australia Study participants completed validated questionnaires and study-specific items. Results: Of 642 adults with type 1 diabetes, 21{\%} reported ≥. 1 severe hypoglycemic event in the past six months, and 21{\%} reported impaired awareness of hypoglycemia (IAH). Severe hypoglycemia was increased four-fold for those with IAH compared with intact awareness (1.4. ±. 3.9 versus 0.3. ±. 1.0). Of those with IAH, 92{\%} perceived autonomic and 88{\%} neuroglycopenic symptoms, albeit at lower glucose thresholds compared to people with intact awareness. Those with IAH were more likely to perceive both symptom types at the same glucose level or to perceive neuroglycopenic symptoms first (all p. <. 0.001). Eighteen percent with IAH treated hypoglycemia only when they perceived symptoms and another 18{\%} only when their capillary glucose was <. 3.0. mmol/L. Conclusions: One in five adults with type 1 diabetes had IAH or experienced severe hypoglycemia in the past six. months. Total loss of hypoglycemia symptoms was rare; most people with IAH retained autonomic symptoms, perceived at relatively low glucose levels. Frequent self-monitoring of blood glucose prompted early recognition and treatment of hypoglycemia, suggesting severe hypoglycemia risk can be minimized.",
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    author = "Christel Hendrieckx and Virginia Hagger and Alicia Jenkins and Skinner, {Timothy Chas} and Frans Pouwer and Jane Speight",
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    Severe hypoglycemia, impaired awareness of hypoglycemia, and self-monitoring in adults with type 1 diabetes : Results from Diabetes MILES-Australia. / Hendrieckx, Christel; Hagger, Virginia; Jenkins, Alicia; Skinner, Timothy Chas; Pouwer, Frans; Speight, Jane.

    In: Journal of Diabetes and Its Complications, Vol. 31, No. 3, 2017, p. 577-582.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Severe hypoglycemia, impaired awareness of hypoglycemia, and self-monitoring in adults with type 1 diabetes

    T2 - Results from Diabetes MILES-Australia

    AU - Hendrieckx, Christel

    AU - Hagger, Virginia

    AU - Jenkins, Alicia

    AU - Skinner, Timothy Chas

    AU - Pouwer, Frans

    AU - Speight, Jane

    PY - 2017

    Y1 - 2017

    N2 - Aims: To assess prevalence of severe hypoglycemia, awareness and symptoms of hypoglycemia, and their associations with self-monitoring of blood glucose. Methods: Diabetes MILES-Australia Study participants completed validated questionnaires and study-specific items. Results: Of 642 adults with type 1 diabetes, 21% reported ≥. 1 severe hypoglycemic event in the past six months, and 21% reported impaired awareness of hypoglycemia (IAH). Severe hypoglycemia was increased four-fold for those with IAH compared with intact awareness (1.4. ±. 3.9 versus 0.3. ±. 1.0). Of those with IAH, 92% perceived autonomic and 88% neuroglycopenic symptoms, albeit at lower glucose thresholds compared to people with intact awareness. Those with IAH were more likely to perceive both symptom types at the same glucose level or to perceive neuroglycopenic symptoms first (all p. <. 0.001). Eighteen percent with IAH treated hypoglycemia only when they perceived symptoms and another 18% only when their capillary glucose was <. 3.0. mmol/L. Conclusions: One in five adults with type 1 diabetes had IAH or experienced severe hypoglycemia in the past six. months. Total loss of hypoglycemia symptoms was rare; most people with IAH retained autonomic symptoms, perceived at relatively low glucose levels. Frequent self-monitoring of blood glucose prompted early recognition and treatment of hypoglycemia, suggesting severe hypoglycemia risk can be minimized.

    AB - Aims: To assess prevalence of severe hypoglycemia, awareness and symptoms of hypoglycemia, and their associations with self-monitoring of blood glucose. Methods: Diabetes MILES-Australia Study participants completed validated questionnaires and study-specific items. Results: Of 642 adults with type 1 diabetes, 21% reported ≥. 1 severe hypoglycemic event in the past six months, and 21% reported impaired awareness of hypoglycemia (IAH). Severe hypoglycemia was increased four-fold for those with IAH compared with intact awareness (1.4. ±. 3.9 versus 0.3. ±. 1.0). Of those with IAH, 92% perceived autonomic and 88% neuroglycopenic symptoms, albeit at lower glucose thresholds compared to people with intact awareness. Those with IAH were more likely to perceive both symptom types at the same glucose level or to perceive neuroglycopenic symptoms first (all p. <. 0.001). Eighteen percent with IAH treated hypoglycemia only when they perceived symptoms and another 18% only when their capillary glucose was <. 3.0. mmol/L. Conclusions: One in five adults with type 1 diabetes had IAH or experienced severe hypoglycemia in the past six. months. Total loss of hypoglycemia symptoms was rare; most people with IAH retained autonomic symptoms, perceived at relatively low glucose levels. Frequent self-monitoring of blood glucose prompted early recognition and treatment of hypoglycemia, suggesting severe hypoglycemia risk can be minimized.

    KW - Impaired awareness of hypoglycemia

    KW - Self-monitoring of blood glucose

    KW - Severe hypoglycemia

    KW - Symptom recognition

    KW - Type 1 diabetes

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