The Biostatistics Research Center for the Impaired Awareness of Hypoglycemia Consortium

摘要 1型糖尿病（T1 D）患者容易反复发生低血糖，这可能导致 低血糖意识受损（IAH）。因此，IAH有助于减少对 需要外部葡萄糖和钝化的反调节反应，需要增加 血糖对于患有IAH的T1 D个体来说，这可能是一种非常危险的情况，可能导致昏迷， 一些情况下，死亡。这对于患有IAH的T1 D个体来说可能是非常危险的情况，可能导致 昏迷甚至死亡许多T1 D研究由于混杂因素而排除了IAH个体 问题.因此，国家糖尿病、消化和肾脏疾病研究所（NIDKK）发布了 两个RFA组成IAH联盟，将调查导致 在患有IAH的成人T1 D个体中恢复对低血糖的认识。RFA-DK-21-020和RFA-DK-21- 036分别申请临床中心和唯一的生物统计学研究中心（BRC）。 IAH联合会的目标是 ·确定最新的管理策略是否使用糖尿病技术来优化HbA 1c 虽然最小化低血糖可以恢复低血糖的意识并改善反调节 T1 D和IAH患者的反应 ·识别范围内的时间的幅度和持续时间、低血糖花费的时间或用于低血糖的其他度量。 与恢复低血糖意识相关的连续血糖监测仪 ·确定当前或新开发的IAH自我报告措施与反 阐明低血糖意识恢复异质性的调节反应 宾夕法尼亚州立大学医学院的公共卫生科学系建议 作为IAH联盟的BRC，并将追求七个具体目标。 具体目标1：在研究的开发和实施方面进行合作，并领导统计分析 具体目标2：领导联合会制定自我报告的IAH措施 具体目标3：设立中心实验室 具体目标4：在利益相关者参与方面领导联盟 具体目标5：开发数据管理和网站流程 具体目标6：保持法规遵从性 具体目标7：提供沟通和项目管理支持

ABSTRACT Individuals with Type 1 Diabetes (T1D) are susceptible to repeated episodes of hypoglycemia, which can result in impaired awareness of hypoglycemia (IAH). As a consequence, IAH contributes to diminished recognition of the need for external glucose and the blunting of counter-regulatory responses that are required to increase blood glucose. This can be a very risky situation for T1D individuals with IAH, possibly leading to coma and in some circumstances, death. This can be a very risky situation for T1D individuals with IAH, possibly leading to coma and in some circumstances, death. Many T1D studies exclude IAH individuals because of confounding issues. Therefore, the National Institute for Diabetes and Digestive and Kidney Diseases (NIDKK) has issued two RFAs to form the IAH Consortium that will investigate factors which contribute to the heterogeneity of restoration of awareness of hypoglycemia in adult T1D individuals with IAH. RFA-DK-21-020 and RFA-DK-21- 036 request applications for Clinical Centers and the sole Biostatistics Research Center (BRC), respectively. The objectives of the IAH Consortium will be to • determine if the most up-to-date management strategies using diabetes technology to optimize HbA1c while minimizing hypoglycemia can restore awareness of hypoglycemia and improve counter-regulatory responses in individuals with T1D and IAH • identify the magnitude and duration of time in range, time spent in hypoglycemia or other metrics for continuous glucose monitors that are associated with restoration of awareness of hypoglycemia • determine the association of current or newly developed self-reported measures of IAH with counter- regulatory responses to elucidate the heterogeneity in restoration of hypoglycemia awareness The Department of Public Health Sciences at The Pennsylvania State University College of Medicine proposes to serve as the BRC for the IAH Consortium, and will pursue seven specific aims. Specific Aim 1: Collaborate on the development and conduct of studies, and lead statistical analyses Specific Aim 2: Lead the Consortium in developing measures of self-reported IAH Specific Aim 3: House a Central Laboratory Specific Aim 4: Lead the Consortium in stakeholder engagement Specific Aim 5: Develop data management and website processes Specific Aim 6: Maintain regulatory compliance Specific Aim 7: Provide communication and project management support