Prevalence of impaired awareness of hypoglycaemia and frequency of hypoglycaemia in insulin-treated type 2 diabetes.
OBJECTIVE
The present study sought to ascertain the prevalence of impaired awareness of hypoglycaemia (IAH) in people with insulin-treated Type 2 diabetes (T2DM) and its effect on risk of hypoglycaemia.


METHODS
Data were obtained from 122 people with insulin-treated T2DM (63 male; mean (SD) HbA1c 8.4% (1.5); median (inter quartile range, IQR) age, 67 (58-72) years; duration of T2DM 15 (10-20) years; duration of insulin therapy, 6 (4-9) years). A questionnaire was used to evaluate hypoglycaemia awareness status and estimate the frequency of severe hypoglycaemia (SH) in the preceding year. Capillary blood glucose was monitored prospectively over a 4-week period to document biochemical hypoglycaemia.


RESULTS
The prevalence of IAH was 9.8%. In the subgroup with IAH the incidence of SH in the preceding year was 17-fold higher than those with normal hypoglycaemia awareness (0.83 (1.12) vs. 0.05 (0.28) episodes per patient; p<0.001 (n=122)) and had a five-fold higher incidence of biochemical hypoglycaemia (2.43 (4.39) vs. 0.46 (1.21) episodes; p<0.001 (n=63)).


CONCLUSIONS
The prevalence of IAH in insulin-treated T2DM was associated with higher frequencies of SH and biochemical hypoglycaemia. Therefore the presence of IAH in those with insulin-treated T2DM should be evaluated at clinical review.
Schopman
Josefine E
JE
Department of Diabetes, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, Scotland, UK.
Geddes
Jacqueline
J
Frier
Brian M
BM
D017668:Age of Onset; D000368:Aged; D001364:Awareness / Q000502:physiology*; D001786:Blood Glucose / Q000032:analysis; D002196:Capillaries / Q000503:physiopathology; D048909:Diabetes Complications / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D004282:Documentation; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology*; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires
D001786:Blood Glucose; D007328:Insulin