目的:低血糖(IAH)意识受损与糖尿病困扰增加有关,使用传感器技术可以减少糖尿病困扰。这项研究的目的是检查糖尿病特有的痛苦(情绪,认知,行为)与1型糖尿病患者的IAH状态和葡萄糖传感器的使用有关。
方法:来自学术糖尿病门诊诊所的1型糖尿病患者填写了Clarke问卷(评估低血糖意识),糖尿病问题领域(PAID-5)低血糖恐惧调查-II(HFS-II),对低血糖调查意识的态度(A2A),奈梅亨临床筛查仪器调查(NCSI)和避免高血糖量表(HAS)。
结果:在422名参与者中(51.9%为男性,糖尿病病程30[16-40]年,HbA1c60±11mmol/mol[7.6±1.0%],351[88.2%]使用葡萄糖传感器;82[19.4%])具有IAH。与意识正常的人相比,IAH患者的PAID-5得分≥8(35.4%与21.5%,p=0.008)和所有HFS-II子分数的更高分数(总计[40.2±21.5vs.27.9±17.2,p<0.001]),HFS-II行为(18.5±10.0与15.1±8.0,p=0.005),HFS-II担心(21.8±13.5vs.12.7±10.9,p<0.001),有担忧(17.5±7.3vs.14.3±7.0,p<0.001)和NCSI低血糖项目。有行为,A2A和NCSI高血糖评分在有或没有IAH的个体之间没有差异。使用葡萄糖传感器将分析限于个体并没有实质性地改变结果。
结论:糖尿病特异性困扰仍然是1型糖尿病患者的主要问题,尤其是那些有IAH的人,尽管广泛使用(间歇性扫描)传感器技术。需要进一步的研究来研究降低IAH患者糖尿病特异性痛苦的策略。
Impaired awareness of hypoglycaemia (IAH) has been associated with increased diabetes distress and use of sensor technology can reduce diabetes distress. The aim of this study was to examine diabetes-specific distress (emotions, cognitions, behaviours) in relation to IAH status and use of glucose sensors in people with type 1 diabetes.
Individuals with type 1 diabetes from an academic diabetes outpatient clinic completed the Clarke questionnaire (to assess hypoglycaemic awareness), Problem Areas in Diabetes (PAID-5), Hypoglycaemia Fear Survey-II (HFS-II), Attitudes to Awareness of Hypoglycaemia Survey (A2A), Nijmegen Clinical Screening Instrument Survey (NCSI) and Hyperglycaemia Avoidance Scale (HAS).
Of the 422 participants (51.9% male, diabetes duration 30 [16-40] years, HbA1c 60 ± 11 mmol/mol [7.6 ± 1.0%], 351 [88.2%] used a glucose sensor; 82 [19.4%]) had IAH. Compared to individuals with normal awareness, those with IAH more often had PAID-5 scores ≥8 (35.4% vs. 21.5%, p = 0.008) and higher scores on all HFS-II subscores (total [40.2 ± 21.5 vs. 27.9 ± 17.2, p < 0.001]), HFS-II behaviour (18.5 ± 10.0 vs. 15.1 ± 8.0, p = 0.005), HFS-II worry (21.8 ± 13.5 vs. 12.7 ± 10.9, p < 0.001), HAS worries (17.5 ± 7.3 vs. 14.3 ± 7.0, p < 0.001) and NCSI hypoglycaemia items. HAS behaviour, A2A and NCSI hyperglycaemia scores did not differ between individuals with or without IAH. Restricting the analyses to individuals using a glucose sensor did not materially change the results.
Diabetes-specific distress remains a major problem among individuals with type 1 diabetes, particularly those with IAH, despite the widespread use of (intermittently scanned) sensor technology. Further studies are needed to examine strategies to lower diabetes-specific distress in individuals with IAH.