Real life evidence that impaired awareness of hypoglycemia persists for years in patients with type 1 diabetes

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Abstract

Aims: To determine if impaired awareness of hypoglycemia in patients with type 1 diabetes persists over time and to assess if continuous glucose monitoring use was associated with improved awareness of hypoglycemia in our population. Methods: Thirty-six with type 1 diabetes and impaired awareness of hypoglycemia who participated in studies on impaired awareness of hypoglycemia between 2009 and 2015 were contacted to complete an online survey. The survey included the Cox/Clarke and Gold hypoglycemia questionnaires and questions about continuous glucose monitoring use. Results: 23 of 36 (63%) subjects contacted completed the survey. (12 M, 11 F; median age 51 years, median diabetes duration 34 years). One had had an islet cell transplant and was excluded. Persistent impaired awareness of hypoglycemia was found in 19/22 (86%) using the Cox questionnaire and 18/22 (82%) using the Gold questionnaire. Consistent use of continuous glucose monitoring over the last six months defined as using a device ≥75% of time over the last 6 months was reported by 67% (12/18) and 68% (13/19) of participants with persistent impaired awareness of hypoglycemia as measured by Gold and Cox; respectively. Nineteen of the 22 participants (86%) reported severe hypoglycemia over the last six months. Conclusion: Impaired awareness of hypoglycemia persisted in >80% of the subjects with type 1 diabetes we studied between 2009 and 2015. While the consistent use of continuous glucose monitoring among our participants was high; it did not translate into restoration of hypoglycemia awareness in this population. This real world data shows that severe hypoglycemia continues to be a frequent problem in this patient population.

Original languageEnglish (US)
Pages (from-to)1097-1099
Number of pages3
JournalJournal of Diabetes and Its Complications
Volume32
Issue number12
DOIs
StatePublished - Dec 1 2018

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Type 1 Diabetes Mellitus
Hypoglycemia
Gold
Glucose
Population
Islets of Langerhans
Surveys and Questionnaires
Transplants
Equipment and Supplies

Keywords

  • Continuous glucose monitor
  • Hypoglycemia
  • Impaired awareness of hypoglycemia
  • Severe hypoglycemia
  • Type 1 diabetes

PubMed: MeSH publication types

  • Journal Article

Cite this

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title = "Real life evidence that impaired awareness of hypoglycemia persists for years in patients with type 1 diabetes",
abstract = "Aims: To determine if impaired awareness of hypoglycemia in patients with type 1 diabetes persists over time and to assess if continuous glucose monitoring use was associated with improved awareness of hypoglycemia in our population. Methods: Thirty-six with type 1 diabetes and impaired awareness of hypoglycemia who participated in studies on impaired awareness of hypoglycemia between 2009 and 2015 were contacted to complete an online survey. The survey included the Cox/Clarke and Gold hypoglycemia questionnaires and questions about continuous glucose monitoring use. Results: 23 of 36 (63{\%}) subjects contacted completed the survey. (12 M, 11 F; median age 51 years, median diabetes duration 34 years). One had had an islet cell transplant and was excluded. Persistent impaired awareness of hypoglycemia was found in 19/22 (86{\%}) using the Cox questionnaire and 18/22 (82{\%}) using the Gold questionnaire. Consistent use of continuous glucose monitoring over the last six months defined as using a device ≥75{\%} of time over the last 6 months was reported by 67{\%} (12/18) and 68{\%} (13/19) of participants with persistent impaired awareness of hypoglycemia as measured by Gold and Cox; respectively. Nineteen of the 22 participants (86{\%}) reported severe hypoglycemia over the last six months. Conclusion: Impaired awareness of hypoglycemia persisted in >80{\%} of the subjects with type 1 diabetes we studied between 2009 and 2015. While the consistent use of continuous glucose monitoring among our participants was high; it did not translate into restoration of hypoglycemia awareness in this population. This real world data shows that severe hypoglycemia continues to be a frequent problem in this patient population.",
keywords = "Continuous glucose monitor, Hypoglycemia, Impaired awareness of hypoglycemia, Severe hypoglycemia, Type 1 diabetes",
author = "K. Zekarias and A. Kumar and Amir Moheet and Seaquist, {Elizabeth R}",
year = "2018",
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language = "English (US)",
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pages = "1097--1099",
journal = "Journal of Diabetes and its Complications",
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T1 - Real life evidence that impaired awareness of hypoglycemia persists for years in patients with type 1 diabetes

AU - Zekarias, K.

AU - Kumar, A.

AU - Moheet, Amir

AU - Seaquist, Elizabeth R

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Aims: To determine if impaired awareness of hypoglycemia in patients with type 1 diabetes persists over time and to assess if continuous glucose monitoring use was associated with improved awareness of hypoglycemia in our population. Methods: Thirty-six with type 1 diabetes and impaired awareness of hypoglycemia who participated in studies on impaired awareness of hypoglycemia between 2009 and 2015 were contacted to complete an online survey. The survey included the Cox/Clarke and Gold hypoglycemia questionnaires and questions about continuous glucose monitoring use. Results: 23 of 36 (63%) subjects contacted completed the survey. (12 M, 11 F; median age 51 years, median diabetes duration 34 years). One had had an islet cell transplant and was excluded. Persistent impaired awareness of hypoglycemia was found in 19/22 (86%) using the Cox questionnaire and 18/22 (82%) using the Gold questionnaire. Consistent use of continuous glucose monitoring over the last six months defined as using a device ≥75% of time over the last 6 months was reported by 67% (12/18) and 68% (13/19) of participants with persistent impaired awareness of hypoglycemia as measured by Gold and Cox; respectively. Nineteen of the 22 participants (86%) reported severe hypoglycemia over the last six months. Conclusion: Impaired awareness of hypoglycemia persisted in >80% of the subjects with type 1 diabetes we studied between 2009 and 2015. While the consistent use of continuous glucose monitoring among our participants was high; it did not translate into restoration of hypoglycemia awareness in this population. This real world data shows that severe hypoglycemia continues to be a frequent problem in this patient population.

AB - Aims: To determine if impaired awareness of hypoglycemia in patients with type 1 diabetes persists over time and to assess if continuous glucose monitoring use was associated with improved awareness of hypoglycemia in our population. Methods: Thirty-six with type 1 diabetes and impaired awareness of hypoglycemia who participated in studies on impaired awareness of hypoglycemia between 2009 and 2015 were contacted to complete an online survey. The survey included the Cox/Clarke and Gold hypoglycemia questionnaires and questions about continuous glucose monitoring use. Results: 23 of 36 (63%) subjects contacted completed the survey. (12 M, 11 F; median age 51 years, median diabetes duration 34 years). One had had an islet cell transplant and was excluded. Persistent impaired awareness of hypoglycemia was found in 19/22 (86%) using the Cox questionnaire and 18/22 (82%) using the Gold questionnaire. Consistent use of continuous glucose monitoring over the last six months defined as using a device ≥75% of time over the last 6 months was reported by 67% (12/18) and 68% (13/19) of participants with persistent impaired awareness of hypoglycemia as measured by Gold and Cox; respectively. Nineteen of the 22 participants (86%) reported severe hypoglycemia over the last six months. Conclusion: Impaired awareness of hypoglycemia persisted in >80% of the subjects with type 1 diabetes we studied between 2009 and 2015. While the consistent use of continuous glucose monitoring among our participants was high; it did not translate into restoration of hypoglycemia awareness in this population. This real world data shows that severe hypoglycemia continues to be a frequent problem in this patient population.

KW - Continuous glucose monitor

KW - Hypoglycemia

KW - Impaired awareness of hypoglycemia

KW - Severe hypoglycemia

KW - Type 1 diabetes

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