目的:这项工作的目的是研究低血糖对1型糖尿病或胰岛素治疗的2型糖尿病成人日常功能的影响。使用新颖的低度量应用程序。
方法:连续70天,594名成人(1型糖尿病,n=274;2型糖尿病,n=320)完成了简短的早晚低血糖症检查和日常功能检查。参与者在研究持续时间内佩戴盲化葡萄糖传感器(即参与者不可用的数据)。使用多水平回归模型比较了有或没有人报告的低血糖(PRH)和/或传感器检测到的低血糖(SDH)的昼夜。
结果:参与者提交了上午86.3±12.5%和晚上90.8±10.7%的平均±SD。对于这两种类型的糖尿病,单独的SDH与日常功能评分的变化没有显着关联。然而,白天和夜间PRH(有或没有SDH)与能量水平的恶化显着相关,心情,认知功能,当天晚些时候或睡着时对低血糖的负面影响和恐惧。此外,夜间PRH(伴或不伴SDH)与睡眠质量(1型和2型糖尿病)和记忆力(2型糖尿病)恶化显著相关.Further,日间PRH(有或没有SDH),与睡眠时对高血糖症的恐惧恶化有关(1型糖尿病),记忆(1型和2型糖尿病)和社会功能(2型糖尿病)。
结论:这种前瞻性,现实世界的研究揭示了PRH后对日常功能的几个领域的影响,而不是单独遵循SDH。这些数据表明,观察到的负面影响主要是由对低血糖(即PRH)的主观意识驱动的。通过症状或传感器警报/读数和/或需要采取行动来预防或治疗发作。
OBJECTIVE: The aim of this work was to examine the impact of
hypoglycaemia on daily functioning among adults with type 1 diabetes or insulin-treated type 2 diabetes, using the novel Hypo-METRICS app.
METHODS: For 70 consecutive days, 594 adults (type 1 diabetes, n=274; type 2 diabetes, n=320) completed brief morning and evening Hypo-METRICS \'check-ins\' about their experienced
hypoglycaemia and daily functioning. Participants wore a blinded glucose sensor (i.e. data unavailable to the participants) for the study duration. Days and nights with or without person-reported
hypoglycaemia (PRH) and/or sensor-detected
hypoglycaemia (SDH) were compared using multilevel regression models.
RESULTS: Participants submitted a mean ± SD of 86.3±12.5% morning and 90.8±10.7% evening check-ins. For both types of diabetes, SDH alone had no significant associations with the changes in daily functioning scores. However, daytime and night-time PRH (with or without SDH) were significantly associated with worsening of energy levels, mood, cognitive functioning, negative affect and fear of
hypoglycaemia later that day or while asleep. In addition, night-time PRH (with or without SDH) was significantly associated with worsening of sleep quality (type 1 and type 2 diabetes) and memory (type 2 diabetes). Further, daytime PRH (with or without SDH), was associated with worsening of fear of hyperglycaemia while asleep (type 1 diabetes), memory (type 1 and type 2 diabetes) and social functioning (type 2 diabetes).
CONCLUSIONS: This prospective, real-world study reveals impact on several domains of daily functioning following PRH but not following SDH alone. These data suggest that the observed negative impact is mainly driven by subjective awareness of
hypoglycaemia (i.e. PRH), through either symptoms or sensor alerts/readings and/or the need to take action to prevent or treat episodes.