Prevalence of self-reported severe hypoglycaemia in adults with type 1 diabetes attending tertiary diabetes clinics in Melbourne — ASN Events
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Prevalence of self-reported severe hypoglycaemia in adults with type 1 diabetes attending tertiary diabetes clinics in Melbourne (#274)

Christel Hendrieckx 1 2 , Jennifer Halliday 1 2 , Joanne Bowden 3 , Peter Colman 3 , Neale Cohen 4 , Alicia Jenkins 5 , Jane Speight 1 2 6
  1. Medtronic, Northridge, United States
  2. Centre for Mental Health and Wellbeing Research, School of Psychology, Deakin University, Burwood, VIC, Australia
  3. Department of Diabetes and Endocrinology, The Royal Melbourne Hospital, Parkville, VIC, Australia
  4. Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
  5. Department of Medicine, St Vincent's Hospital, Melbourne, Victoria, Australia
  6. AHP Research, Hornchurch, Essex, UK

Aim

The aim of this study was to examine self-reported prevalence of severe hypoglycaemia (SH) in unselected adults with type 1 diabetes (T1DM) attending one of three tertiary, metropolitan diabetes clinics, and its association with psychological well-being.

Method

Over a 12–week period, all clinic attendees were invited to complete a questionnaire while awaiting their consultation with an endocrinologist. Questions asked about frequency of SH in the past 6 months, defined as ’a hypo where you needed help/were unable to treat yourself’; impaired awareness of hypoglycemia (IAH), assessed with the ”Gold-score”, a one-item 7-point scale with scores ≥4 indicating IAH. Two validated scales (PAID and WHO-5) measured diabetes-related distress and general psychological well-being respectively.

Results

In total, 440 adults with T1DM participated: mean±SD age 38±15 years; diabetes duration 18±12 years; HbA1c 7.9±1.3%. Over half (53%) were women, 25% used an insulin pump. Nineteen percent (N=78) experienced at least one SH event in the past 6 months. A total of 194 episodes were reported by these 78 participants (mean 2.5 episodes/person/6 months); 10 people experienced 40% of the episodes. Twenty-one percent (N=91) had IAH.

Compared with those who did not report SH, those who experienced SH had a longer diabetes duration (21.5±12.3 versus 17.7±11.7 years, p<0.01), were more likely to have  IAH  (46% versus 15%, p<0.01), poorer well-being (50.2±21.3 versus 59.0±20.8, p<0.01) and higher diabetes-related distress (28.5±19.2 versus 21.2±16.1, p<0.01). There was no association with age, gender, insulin delivery (injections/pump) or HbA1c.

Conclusion

In this unselected clinic population, one in four adults with T1DM reported at least one SH event in the past six months, with a small number experiencing the majority of episodes. These results underline the need to  relax glycaemic targets in this high risk group and/or to implement educational interventions to restore hypoglycaemia awareness and reduce SH.