Details

Autor(en) / Beteiligte

• Olsen, S. E.
• Åsvold, B. O.
• Frier, B. M.
• Aune, S. E.
• Hansen, L. I.
• Bjørgaas, M. R.

Titel

Hypoglycaemia symptoms and impaired awareness of hypoglycaemia in adults with Type 1 diabetes: the association with diabetes duration

Ist Teil von

• Diabetic medicine, 2014-10, Vol.31 (10), p.1210-1217

Ort / Verlag

Oxford: Blackwell Publishing Ltd

Erscheinungsjahr

2014

Quelle

MEDLINE

Beschreibungen/Notizen

• Aims To examine the association between diabetes duration and hypoglycaemia symptom profiles and the presence of impaired awareness of hypoglycaemia. Methods A cross‐sectional study was performed, using validated methods for recording hypoglycaemia symptoms and assessing hypoglycaemia awareness. The associations between symptom intensity, hypoglycaemia awareness and diabetes duration were examined, and the prevalence of impaired awareness was ascertained for Type 1 diabetes of differing durations. Results Questionnaires were mailed to 636 adults with Type 1 diabetes, of whom 445 (70%) returned them. A total of 440 completed questionnaires were suitable for analysis. Longer diabetes duration was associated with lower intensity of autonomic symptoms (P for trend <0.001), but no association was observed with neuroglycopenic symptoms. The overall prevalence of impaired awareness of hypoglycaemia in this cohort was 17% (95% CI 14–21%) and increased with diabetes duration, from 3% for duration 2–9 years to 28% for duration ≥30 years (P for trend <0.001). Low autonomic symptom scores were not associated with a higher prevalence of impaired awareness. Conclusions Longer diabetes duration was associated with lower intensity of autonomic symptoms and a higher prevalence of impaired awareness of hypoglycaemia, suggesting that subjective symptoms of hypoglycaemia change over time. These observations underline the need for regular patient education about hypoglycaemia symptomatology and clinical screening for impaired awareness of hypoglycaemia. What's new? In this cross‐sectional study, duration of Type 1 diabetes was associated with a lower intensity of the autonomic symptoms of hypoglycaemia, but not with the intensity of neuroglycopenic symptoms. In particular, longer diabetes duration was associated with a lower intensity of the autonomic symptoms of trembling, hunger and sweating. Low autonomic symptom scores were not associated with a greater prevalence of impaired awareness of hypoglycaemia, which was more evident in people who reported a high intensity of neuroglycopenic symptoms. These observations suggest that both the intensity of autonomic symptoms and subjective awareness of hypoglycaemia decline with increasing duration of Type 1 diabetes.