Abstract：
Impaired awareness of hypoglycaemia (IAH) has been reported to affect up to a third of people with type 1 diabetes. Whether the increased use of sensor technology has changed its prevalence remains unknown. The aim of this study was to investigate the current prevalence of IAH and its change over time in a cohort of individuals with type 1 diabetes.
IAH was assessed using the modified Clarke questionnaire in adults with type 1 diabetes. Participants were recruited from the diabetes outpatient clinic from February 2020 through April 2021. The scores were compared to similar data collected during previous assessments in 2006, 2010 and 2016 respectively.
A total of 488 individuals (51.2% male) with a mean (±SD) age of 51.3 ± 15.9 years, median [Q1-Q3] diabetes duration of 30 [16-40] years and mean HbA1c of 60 ± 12 mmol/mol (7.7 ± 1.1%) were included. Sensors were used by 85% of the study population. IAH was present among 78 (16.0%) participants, whereas 86 (17.6%) participants had a history of severe hypoglycaemia. By comparison, the prevalence of IAH equalled 32.5% in 2006, 32.3% in 2010 and 30.1% in 2016 (p for trend <0.001), while the proportion of individuals reporting severe hypoglycaemia equalled 21.2%, 46.7% and 49.8% respectively (p for trend 0.010). Comparing sequential assessments over time, the proportion of individuals with persistent IAH decreased from 74.0% and 63.6% between 2006 and 2016 to 32.5% in 2020.
Among individuals with type 1 diabetes and high use of sensor technology, the current prevalence of IAH was 16%, about 50% lower as compared to previous years.
IAH was assessed using the modified Clarke questionnaire in adults with type 1 diabetes. Participants were recruited from the diabetes outpatient clinic from February 2020 through April 2021. The scores were compared to similar data collected during previous assessments in 2006, 2010 and 2016 respectively.
A total of 488 individuals (51.2% male) with a mean (±SD) age of 51.3 ± 15.9 years, median [Q1-Q3] diabetes duration of 30 [16-40] years and mean HbA1c of 60 ± 12 mmol/mol (7.7 ± 1.1%) were included. Sensors were used by 85% of the study population. IAH was present among 78 (16.0%) participants, whereas 86 (17.6%) participants had a history of severe hypoglycaemia. By comparison, the prevalence of IAH equalled 32.5% in 2006, 32.3% in 2010 and 30.1% in 2016 (p for trend <0.001), while the proportion of individuals reporting severe hypoglycaemia equalled 21.2%, 46.7% and 49.8% respectively (p for trend 0.010). Comparing sequential assessments over time, the proportion of individuals with persistent IAH decreased from 74.0% and 63.6% between 2006 and 2016 to 32.5% in 2020.
Among individuals with type 1 diabetes and high use of sensor technology, the current prevalence of IAH was 16%, about 50% lower as compared to previous years.
摘要：
目的：据报道，对低血糖（IAH）的认知受损影响了1/3的1型糖尿病患者。传感器技术的使用增加是否改变了其普遍性仍然未知。这项研究的目的是调查1型糖尿病患者队列中IAH的当前患病率及其随时间的变化。
方法：在1型糖尿病成人中使用改良Clarke问卷评估IAH。参与者从2020年2月至2021年4月从糖尿病门诊招募。这些分数分别与2006年、2010年和2016年之前评估期间收集的类似数据进行了比较。
结果：共有488名个体（男性占51.2％），平均（±SD）年龄为51.3±15.9岁，中位[Q1-Q3]糖尿病持续时间为30[16-40]年,平均HbA1c为60±12mmol/mol(7.7±1.1%).85%的研究人群使用了传感器。IAH出现在78名(16.0%)参与者中，86名(17.6%)参与者有严重低血糖病史.相比之下,IAH的患病率在2006年为32.5%，2010年为32.3%，2016年为30.1%(趋势p<0.001)，而报告严重低血糖的个体比例等于21.2%，分别为46.7%和49.8%（趋势0.010的p值）。比较一段时间内的顺序评估，患有持续性IAH的个体比例从2006年至2016年的74.0%和63.6%下降至2020年的32.5%.
结论：在1型糖尿病和高度使用传感器技术的个体中，目前IAH的患病率为16%，与前几年相比降低了约50%。
方法：在1型糖尿病成人中使用改良Clarke问卷评估IAH。参与者从2020年2月至2021年4月从糖尿病门诊招募。这些分数分别与2006年、2010年和2016年之前评估期间收集的类似数据进行了比较。
结果：共有488名个体（男性占51.2％），平均（±SD）年龄为51.3±15.9岁，中位[Q1-Q3]糖尿病持续时间为30[16-40]年,平均HbA1c为60±12mmol/mol(7.7±1.1%).85%的研究人群使用了传感器。IAH出现在78名(16.0%)参与者中，86名(17.6%)参与者有严重低血糖病史.相比之下,IAH的患病率在2006年为32.5%，2010年为32.3%，2016年为30.1%(趋势p<0.001)，而报告严重低血糖的个体比例等于21.2%，分别为46.7%和49.8%（趋势0.010的p值）。比较一段时间内的顺序评估，患有持续性IAH的个体比例从2006年至2016年的74.0%和63.6%下降至2020年的32.5%.
结论：在1型糖尿病和高度使用传感器技术的个体中，目前IAH的患病率为16%，与前几年相比降低了约50%。
