Abstract：
We aim to compare and correlate Gold and Clarke questionnaire scores with hypoglycaemic symptomatic responses between insulin-treated type 2 diabetes participants with and without IAH in a real-life study.
Insulin-treated type 2 diabetes participants attending an outpatient diabetes clinic in Singapore were asked to complete the Gold and Clarke questionnaires, record capillary blood glucose (CBG) and hypoglycaemic symptoms for 4 weeks.
Data were collected from 153 participants (M:F = 98:55) with mean age 61.0 ± 9.4 years, duration of diabetes 19.5 ± 8.8 years and HbA1c 68 ± 17 mmol/mol (8.4 ± 1.5%). Gold and Clarke methods classified 19.6% and 26.8% of participants with IAH, respectively. Using CBG threshold of <3 mmol/L, significantly greater proportion of participants with intact awareness were experiencing autonomic symptoms than those with IAH with either method (Gold: 69% vs. 18%, p = 0.006; Clarke: 85% vs. 46%, p = 0.010). Significantly greater proportion of participants with IAH experienced no hypoglycaemia symptoms than those with intact awareness (Gold: 3.4% vs. 36%, p = 0.015; Clarke: 3.7% vs. 31%, p = 0.031). Participants with IAH had significantly higher rates of severe hypoglycaemia in the preceding year compared to those without (Gold: 17% vs. 3.3%; Clarke: 15% vs. 2.7%, p = 0.012).
Gold and Clarke questionnaires are appropriate tools in ascertaining IAH status in insulin-treated type 2 diabetes participants. This is the first time whereby the hypoglycaemia symptomology has robustly validated the Gold and Clarke questionnaire in insulin-treated type 2 diabetes participants.
Insulin-treated type 2 diabetes participants attending an outpatient diabetes clinic in Singapore were asked to complete the Gold and Clarke questionnaires, record capillary blood glucose (CBG) and hypoglycaemic symptoms for 4 weeks.
Data were collected from 153 participants (M:F = 98:55) with mean age 61.0 ± 9.4 years, duration of diabetes 19.5 ± 8.8 years and HbA1c 68 ± 17 mmol/mol (8.4 ± 1.5%). Gold and Clarke methods classified 19.6% and 26.8% of participants with IAH, respectively. Using CBG threshold of <3 mmol/L, significantly greater proportion of participants with intact awareness were experiencing autonomic symptoms than those with IAH with either method (Gold: 69% vs. 18%, p = 0.006; Clarke: 85% vs. 46%, p = 0.010). Significantly greater proportion of participants with IAH experienced no hypoglycaemia symptoms than those with intact awareness (Gold: 3.4% vs. 36%, p = 0.015; Clarke: 3.7% vs. 31%, p = 0.031). Participants with IAH had significantly higher rates of severe hypoglycaemia in the preceding year compared to those without (Gold: 17% vs. 3.3%; Clarke: 15% vs. 2.7%, p = 0.012).
Gold and Clarke questionnaires are appropriate tools in ascertaining IAH status in insulin-treated type 2 diabetes participants. This is the first time whereby the hypoglycaemia symptomology has robustly validated the Gold and Clarke questionnaire in insulin-treated type 2 diabetes participants.
摘要：
目的：我们的目的是比较和关联Gold和Clarke问卷评分和低血糖症状反应在有和没有IAH的胰岛素治疗的2型糖尿病参与者在现实生活中的研究。
方法：在新加坡门诊糖尿病诊所就诊的胰岛素治疗的2型糖尿病参与者被要求填写Gold和Clarke问卷，记录毛细血管血糖（CBG）和低血糖症状4周。
结果：数据来自153名参与者（M：F=98：55），平均年龄为61.0±9.4岁，糖尿病持续时间为19.5±8.8年，HbA1c为68±17mmol/mol（8.4±1.5％）。Gold和Clarke方法分别将19.6％和26.8％的IAH参与者分类。使用<3mmol/l的CBG阈值，与使用任何一种方法的IAH患者相比，具有完整意识的参与者出现自主神经症状的比例明显更高（Gold：69％vs18％，p=0.006；克拉克：85%对46%，p=0.010)。与具有完整意识的参与者相比，IAH参与者没有出现低血糖症状的比例明显更高（Gold：3.4％vs36％，p=0.015；克拉克：3.7%对31%，p=0.031)。与没有IAH的参与者相比，在过去一年中严重低血糖的发生率明显更高（Gold：17％vs3.3％；Clarke：15％vs2.7％，p=0.012)。
结论：Gold和Clarke问卷是确定胰岛素治疗2型糖尿病参与者IAH状态的合适工具。这是低血糖症状学首次在胰岛素治疗的2型糖尿病参与者中有力地验证了Gold和Clarke问卷。
方法：在新加坡门诊糖尿病诊所就诊的胰岛素治疗的2型糖尿病参与者被要求填写Gold和Clarke问卷，记录毛细血管血糖（CBG）和低血糖症状4周。
结果：数据来自153名参与者（M：F=98：55），平均年龄为61.0±9.4岁，糖尿病持续时间为19.5±8.8年，HbA1c为68±17mmol/mol（8.4±1.5％）。Gold和Clarke方法分别将19.6％和26.8％的IAH参与者分类。使用<3mmol/l的CBG阈值，与使用任何一种方法的IAH患者相比，具有完整意识的参与者出现自主神经症状的比例明显更高（Gold：69％vs18％，p=0.006；克拉克：85%对46%，p=0.010)。与具有完整意识的参与者相比，IAH参与者没有出现低血糖症状的比例明显更高（Gold：3.4％vs36％，p=0.015；克拉克：3.7%对31%，p=0.031)。与没有IAH的参与者相比，在过去一年中严重低血糖的发生率明显更高（Gold：17％vs3.3％；Clarke：15％vs2.7％，p=0.012)。
结论：Gold和Clarke问卷是确定胰岛素治疗2型糖尿病参与者IAH状态的合适工具。这是低血糖症状学首次在胰岛素治疗的2型糖尿病参与者中有力地验证了Gold和Clarke问卷。
