Fall in prevalence of impaired awareness of hypoglycaemia in individuals with type 1 diabetes
Fall in prevalence of impaired awareness of hypoglycaemia in individuals with type 1 diabetes
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DOI：
10.1111/dme.15042
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发表时间：
2023-01-21
影响因子：
3.5
通讯作者：
de Galan, Bastiaan E.
中科院分区：
文献类型：
--
作者：
Ali, Namam;El Hamdaoui, Soumia;de Galan, Bastiaan E.
目的：据报道，低血糖意识受损（IAH）影响多达三分之一的1型糖尿病患者。传感器技术使用的增加是否改变了其流行程度仍不得而知。本研究的目的是调查目前的发病率IAH及其随时间的变化在一个队列的个人与1型diabetes.Methods：IAH进行了评估，使用改良的Clarke问卷在成人1型糖尿病。参与者从2020年2月至2021年4月从糖尿病门诊招募。这些分数分别与2006年、2010年和2016年的评估中收集的类似数据进行了比较。共488人（51.2%男性），平均（+/- SD）年龄为51.3 +/- 15.9岁，纳入的中位[Q1-Q3]糖尿病病程为30 [16-40]年，平均HbA（1c）为60 +/- 12 mmol/mol（7.7 +/- 1.1%）。85%的研究人群使用了探头。78例（16.0%）受试者存在IAH，而86例（17.6%）受试者有重度低血糖病史。相比之下，IAH的患病率在2006年、2010年和2016年分别为32.5%、32.3%和30.1%（趋势p < 0.001），而报告重度低血糖的个体比例分别为21.2%、46.7%和49.8%（趋势p <0.010）。随着时间的推移，持续性IAH的比例从2006年至2016年的74.0%和63.6%下降到2020年的32.5%。结论：在1型糖尿病和传感器技术使用率高的人群中，IAH的当前患病率为16%，比前几年下降约50%。
Aims: Impaired awareness of hypoglycaemia (IAH) has been reported to affect up to a third of people with type 1 diabetes. Whether the increased use of sensor technology has changed its prevalence remains unknown. The aim of this study was to investigate the current prevalence of IAH and its change over time in a cohort of individuals with type 1 diabetes.Methods: IAH was assessed using the modified Clarke questionnaire in adults with type 1 diabetes. Participants were recruited from the diabetes outpatient clinic from February 2020 through April 2021. The scores were compared to similar data collected during previous assessments in 2006, 2010 and 2016 respectively.Results: A total of 488 individuals (51.2% male) with a mean (+/- SD) age of 51.3 +/- 15.9 years, median [Q1-Q3] diabetes duration of 30 [16-40] years and mean HbA(1c) of 60 +/- 12 mmol/mol (7.7 +/- 1.1%) were included. Sensors were used by 85% of the study population. IAH was present among 78 (16.0%) participants, whereas 86 (17.6%) participants had a history of severe hypoglycaemia. By comparison, the prevalence of IAH equalled 32.5% in 2006, 32.3% in 2010 and 30.1% in 2016 (p for trend < 0.001), while the proportion of individuals reporting severe hypoglycaemia equalled 21.2%, 46.7% and 49.8% respectively (p for trend 0.010). Comparing sequential assessments over time, the proportion of individuals with persistent IAH decreased from 74.0% and 63.6% between 2006 and 2016 to 32.5% in 2020.Conclusions: Among individuals with type 1 diabetes and high use of sensor technology, the current prevalence of IAH was 16%, about 50% lower as compared to previous years.