Department of Diabetes, Royal Infirmary of Edinburgh, Edinburgh, UK.
Diabet Med. 2011 Mar;28(3):352-5. doi: 10.1111/j.1464-5491.2010.03203.x.
To characterize the frequency and the nature (symptomatic vs. asymptomatic) of hypoglycaemia in people with Type 1 diabetes with impaired awareness of hypoglycaemia.
A group of 19 patients with Type 1 diabetes with normal hypoglycaemia awareness were matched for age, sex, duration of diabetes and glycaemic control with 19 patients with impaired awareness of hypoglycaemia. Frequency of severe hypoglycaemia in the preceding year was estimated retrospectively. Capillary blood glucose was monitored prospectively four times daily, over a 4-week period. All blood glucose values < 3 mmol/l were recorded and classified by symptom response.
The patients with impaired awareness of hypoglycaemia exhibited twice the frequency of all episodes of hypoglycaemia over the 4-week monitoring period than those with normal awareness (mean ±sd 7.9 ± 5.4 vs. 3.7 ± 3.6, P = 0.003). No differences between the two subgroups were observed in the total number of symptomatic hypoglycaemia episodes (4.2 ± 3.3 vs. 3.2 ± 3.4, P = 0.25). The group with impaired awareness of hypoglycaemia had a sevenfold higher incidence of asymptomatic hypoglycaemia than those with normal awareness (3.7 ± 5.3 vs. 0.5 ± 1.2, P = 0.001); these episodes comprised 47% of all glucose values < 3.0 mmol/l in this group, compared with 14% in the normal awareness group. The annual prevalence of severe hypoglycaemia for patients with impaired awareness of hypoglycaemia was 53% compared with 5% for patients with normal awareness, and these patients had a significantly higher incidence of severe events (1.6 ± 2.8 vs. 0.1 ± 0.3, P = 0.001).
Adults with Type 1 diabetes who have impaired awareness of hypoglycaemia are exposed to a much higher incidence of asymptomatic hypoglycaemia than those with normal awareness and are at higher risk of developing severe hypoglycaemia.
描述伴无症状低血糖意识受损的 1 型糖尿病患者低血糖的发生频率和性质（症状性与无症状性）。
将 19 例伴无症状低血糖意识受损的 1 型糖尿病患者与 19 例低血糖意识受损的患者相匹配，年龄、性别、糖尿病病程和血糖控制情况。回顾性估计前一年严重低血糖发作的频率。在 4 周的时间内，每天监测 4 次毛细血管血糖。记录所有 < 3 mmol/l 的血糖值，并根据症状反应进行分类。
在 4 周监测期间，伴无症状低血糖意识受损的患者发生所有低血糖发作的频率是有正常低血糖意识患者的两倍（均值 ± 标准差 7.9 ± 5.4 比 3.7 ± 3.6，P = 0.003）。两组患者的症状性低血糖发作总数无差异（4.2 ± 3.3 比 3.2 ± 3.4，P = 0.25）。伴无症状低血糖意识受损的患者无症状性低血糖的发生率比有正常低血糖意识的患者高 7 倍（3.7 ± 5.3 比 0.5 ± 1.2，P = 0.001）；这些发作占该组所有 < 3.0 mmol/l 血糖值的 47%，而正常意识组为 14%。伴无症状低血糖意识受损的患者严重低血糖的年发生率为 53%，而有正常低血糖意识的患者为 5%，且这些患者严重事件的发生率明显更高（1.6 ± 2.8 比 0.1 ± 0.3，P = 0.001）。
伴无症状低血糖意识受损的 1 型糖尿病成人发生无症状性低血糖的频率明显高于有正常低血糖意识的患者，发生严重低血糖的风险更高。
