Zhu Ling, Ang Li Chang, Tan Wee Boon, Xin Xiaohui, Bee Yong Mong, Goh Su-Yen, Teh Ming Ming
Department of Endocrinology, Singapore General Hospital, 20 College Road, Singapore 169856, Singapore.
Academic Clinical Program, Division of Medicine, Singapore General Hospital, Singapore.
Ther Adv Endocrinol Metab. 2017 May;8(5):69-74. doi: 10.1177/2042018817707422. Epub 2017 May 5.
Impaired awareness of hypoglycaemia (IAH) predisposes affected patients to severe hypoglycaemia. There are few data on prevalence of IAH in adults with insulin-treated type 2 diabetes in Asia. We aim to ascertain the prevalence of IAH among insulin-treated patients with type 2 diabetes in an outpatient clinic in a tertiary care centre in Singapore.
A total of 374 patients with insulin-treated type 2 diabetes attending the outpatient diabetes clinic in a tertiary referral centre in Singapore were recruited over a 4-month period. Participants completed a questionnaire to document baseline characteristics and assess their hypoglycaemia awareness status, using a combination of the Clarke, Gold and Pedersen-Bjergaard methods.
Using the Clarke, Gold and Pedersen-Bjergaard methods, prevalence of IAH in our cohort was 9.6%, 13.4% and 33.2% respectively. Overall, 7.2% of participants suffered from severe hypoglycaemia in the preceding year. The IAH group had more episodes of severe hypoglycaemia across all three methods, compared with the normal awareness group ( < 0.01). There were no significant differences in mean HbA1c, duration of diabetes and insulin treatment between the IAH and normal awareness groups.
IAH is prevalent in adults with insulin-treated type 2 diabetes in Asia, and is associated with significantly increased risk of severe hypoglycaemia.
低血糖意识受损（IAH）使受影响的患者易发生严重低血糖。关于亚洲胰岛素治疗的2型糖尿病成人患者中IAH患病率的数据较少。我们旨在确定新加坡一家三级医疗中心门诊中接受胰岛素治疗的2型糖尿病患者中IAH的患病率。
在4个月的时间里，招募了新加坡一家三级转诊中心门诊糖尿病诊所的374例接受胰岛素治疗的2型糖尿病患者。参与者完成一份问卷，以记录基线特征，并使用克拉克、戈尔德和佩德森 - 比耶加德方法相结合的方式评估他们的低血糖意识状态。
使用克拉克、戈尔德和佩德森 - 比耶加德方法，我们队列中IAH的患病率分别为9.6%、13.4%和33.2%。总体而言，7.2%的参与者在前一年发生过严重低血糖。与正常意识组相比，IAH组在所有三种方法中严重低血糖发作次数更多（<0.01）。IAH组和正常意识组之间的平均糖化血红蛋白、糖尿病病程和胰岛素治疗时间无显著差异。
IAH在亚洲接受胰岛素治疗的2型糖尿病成人中普遍存在，并且与严重低血糖风险显著增加相关。
