A Real‐Life Comparison of Hypoglycaemia Symptomatology between Insulin‐treated Type 2 Diabetes Participants with and without Impaired Awareness of Hypoglycaemia (IAH )
Wai Kit Lee, Michelle Shi Min Ko, Li Chang Ang, Ling Zhu, Yong Mong Bee, Su Yen Goh, Ming Ming Teh - Endocrinology
- Endocrinology, Diabetes and Metabolism
- Internal Medicine
Abstract
Aims
We aim to compare and correlate Gold and Clarke questionnaire scores with hypoglycaemic symptomatic responses between insulin‐treated Type 2 Diabetes participants with and without IAH in a real‐life study.
Methods
Insulin‐treated Type 2 Diabetes participants attending an outpatient diabetes clinic in Singapore were asked to complete the Gold and Clarke questionnaires, record capillary blood glucose (CBG) and hypoglycaemic symptoms for four weeks.
Results
Data were collected from 153 participants (M:F = 98:55) with mean age 61.0 ± 9.4 years, duration of diabetes 19.5 ± 8.8 years and HbA1c 68 ± 17 mmol/mol (8.4 ± 1.5%). Gold and Clarke methods classified 19.6 % and 26.8% of participants with IAH respectively. Using CBG threshold of <3 mmol/l, significantly greater proportion of participants with intact awareness were experiencing autonomic symptoms than those with IAH with either method (Gold: 69% vs 18%, p=0.006; Clarke: 85% vs 46%, p=0.010). Significantly greater proportion of participants with IAH experienced no hypoglycaemia symptoms than those with intact awareness (Gold: 3.4% vs 36%, p=0.015; Clarke: 3.7% vs 31%, p=0.031). Participants with IAH had significantly higher rates of severe hypoglycaemia in the preceding year compared to those without (Gold: 17% vs 3.3%; Clarke: 15% vs 2.7%, p=0.012).
Conclusions
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.