Prevalence of impaired awareness of hypoglycaemia in adults with Type 1 diabetes
Prevalence of impaired awareness of hypoglycaemia in adults with Type 1 diabetes
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DOI：
10.1111/j.1464-5491.2008.02413.x
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发表时间：
2008-04-01
影响因子：
3.5
通讯作者：
Frier, B. M.
中科院分区：
文献类型：
--
作者：
Geddes, J.;Schopman, J. E.;Frier, B. M.
低血糖意识受损（IAH）被认为影响约25%的1型糖尿病患者。虽然这一估计是基于几年前进行的几个小的研究中的患者的回顾性信息，验证的评估方法还没有被用于在一个大型医院的临床为基础的人口，以确定在本时代的患病率。参与者完成了一份调查问卷，记录基线特征和评估他们的意识状态使用的方法描述的黄金等。他们在过去一年中经历的严重低血糖发作的数量进行了回顾性recording.Results IAH是目前在19.5%的队列。与低血糖意识正常的患者相比，IAH患者年龄明显偏大[平均值+/-标准差（SD）; 39.3 +/- 12.9 vs. 45.9 +/- 13.5年，P < 0.001]，糖尿病持续时间较长[中位数（四分位距）14（8-22）vs. 23（14-32）岁，P < 0.001]，并且在前一年中重度低血糖的发生率高出6倍[0.38 +/- 1.04（25 - 75百分位数0-0）vs. 2.36 +/- 4.81（25 - 75百分位数0-2）次/人，P < 0.001].结论目前对一家大型医院门诊人群的调查证实，有相当比例的1型糖尿病患者（19.5%）继续患有IAH。尽管胰岛素治疗、强化胰岛素治疗方案和创新的患者教育有所改善，但1型糖尿病中IAH的患病率仍然很高。
Aims Impaired awareness of hypoglycaemia (IAH) is thought to affect approximately 25% of people with Type 1 diabetes. While this estimate was based on retrospective information from patients in several small studies performed several years ago, validated methods of assessment have not been used in a large hospital clinic-based population to ascertain the prevalence in the present era.Methods Five hundred and eighteen people with Type 1 diabetes were recruited by random selection over a 2-year period. Participants completed a questionnaire documenting baseline characteristics and assessment of their awareness status using the method described by Gold et al. The number of episodes of severe hypoglycaemia they had experienced in the preceding year was recorded retrospectively.Results IAH was present in 19.5% of the cohort. Compared to those with normal awareness of hypoglycaemia, those with IAH were significantly older [mean +/- standard deviation (SD); 39.3 +/- 12.9 vs. 45.9 +/- 13.5 years, P < 0.001], had a longer duration of diabetes [median (interquartile range) 14 (8-22) vs. 23 (14-32) years, P < 0.001], and had a six-fold higher frequency of severe hypoglycaemia in the previous year [0.38 +/- 1.04 (25th-75th centile 0-0) vs. 2.36 +/- 4.81 (25th-75th centile 0-2) episodes per person, P < 0.001].Conclusions The present survey of a large hospital-based clinic population has confirmed that a significant proportion of people with Type 1 diabetes (19.5%) continue to have IAH. Despite improvements in insulin therapies, intensification of insulin regimens and innovative patient education, the prevalence of IAH remains high in Type 1 diabetes.