Endocrine Abstracts

Objective: The aim of this study was to assess prevalence of impaired awareness of hypoglycaemia (IAH) by the Gold method in people with type 1 diabetes and to compare people with and with IAH regarding metabolic control.

Methods: In a cross-sectional study, we assessed IAH in 139 people with type 1 diabetes (54.1y, diabetes duration 24.0y, HbA1c 7.1%) attending the University outpatient department for endocrinology and metabolic diseases. IAH was assessed using the Gold method by asking the question “Do you know when your hypos are commencing?” while scoring on a Lickert scale from 1 (“always”) to 7 (“never”). A Gold score ≥4 is considered as IAH.

Results: Impaired awareness of hypoglycaemia had 25.2% (n=35/139) of the participants. Individuals with IAH had a longer diabetes duration (56.5±13.3 vs. 53.2±14.4 years, P=0.001) and lower threshold of blood glucose level when noticing first symptoms of hypoglycaemia (3.0±1.2 vs. 3.7±0.6 mmol/l, P=0.006) than people with normal awareness. Furthermore, people with IAH had more episodes of hypoglycaemia without symptoms (1-3 events per month: 31.4 vs. 17.5%, 1-3 per week: 37.2 vs. 17.5%). We did not find a difference of PAID Score in patients with and without IAH had (score 19.1 vs. 17.8 out of 100). There were also no differences regarding number of non severe an severe hypoglycaemia, satisfaction of diabetes treatment social status and HbA1c (7.0% vs. 7.2%, P=0.363), in individuals with IAH compared to normal awareness.

Conclusions: One out of four individuals with type 1 diabetes showed IAH. Risk of hypoglycaemia without symptoms is higher in people with IAH despite HbA1c is comparable between patients with IAH and normal awareness. To reduce risk of hypoglycaemia, glucose targets should be adjusted in people with IAH.