Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Exercise Physiology, Training & Training Therapy Research Group, Institute of Sports Science, University of Graz, Graz, Austria.
Diabet Med. 2020 Dec;37(12):2153-2159. doi: 10.1111/dme.14362. Epub 2020 Jul 16.
Considering that people with type 1 diabetes and impaired awareness of hypoglycaemia (IAH) have a delayed perception of hypoglycaemia, the question arises whether they perform scans later in case of hypoglycaemia than people without IAH. We assessed whether time to performing a scan after reaching hypoglycaemia while using a flash glucose monitoring (flash GM) system is different in people with IAH compared with people without IAH.
Ninety-two people with type 1 diabetes [mean (± sd) age 42 ± 14 years, HbA 57 ± 9 mmol/mol] using a flash GM system for 3 months were included. Flash GM data were assessed for time until scan after reaching hypoglycaemia level 1 (< 3.9 mmol/l) and level 2 (< 3.0 mmol/l) and compared for type 1 diabetes with vs. without IAH via unpaired t-test/Mann-Whitney U test (P < 0.05).
Significant differences were found only for the delay between reaching hypoglycaemia and scan between people with and without IAH for Gold score [hypoglycaemia level 1: IAH 78 (51-105) min vs. without IAH 63 (42-89) min, P = 0.03; night-time hypoglycaemia level 2: IAH 140 (107-227) min vs. without IAH 96 (41-155) min, P = 0.004] and Pedersen-Bjergaard score [hypoglycaemia level 1: IAH 76 (52-97) min vs. without IAH 54 (38-71) min, P = 0.011; night-time hypoglycaemia level 1: IAH 132 (79-209) min vs. without IAH 89 (59-143) min, P = 0.011; night-time hypoglycaemia level 2: IAH 134 (66-212) min vs. without IAH 80 (37-131) min, P = 0.002). Data are shown as median (i.q.r.).
Time until scan after reaching hypoglycaemia might be an objective assessment tool for IAH, but needs to be investigated comprehensively in future studies.
考虑到 1 型糖尿病患者和无症状性低血糖（IAH）患者对低血糖的感知延迟，他们在出现低血糖时是否会比没有 IAH 的人更晚进行扫描。我们评估了在使用闪光葡萄糖监测（flash GM）系统时，IAH 患者与无 IAH 患者在达到低血糖后进行扫描的时间是否不同。
纳入了 92 名使用 flash GM 系统 3 个月的 1 型糖尿病患者[平均（±标准差）年龄 42±14 岁，HbA1c57±9mmol/mol]。评估 flash GM 数据在达到低血糖水平 1（<3.9mmol/L）和水平 2（<3.0mmol/L）后扫描的时间，并通过配对 t 检验/Mann-Whitney U 检验比较 1 型糖尿病患者与无 IAH 患者的差异（P<0.05）。
仅在 IAH 患者与无 IAH 患者之间发现了达到低血糖与扫描之间的 Gold 评分[低血糖水平 1：IAH 78（51-105）min 与无 IAH 63（42-89）min，P=0.03；夜间低血糖水平 2：IAH 140（107-227）min 与无 IAH 96（41-155）min，P=0.004]和 Pedersen-Bjergaard 评分[低血糖水平 1：IAH 76（52-97）min 与无 IAH 54（38-71）min，P=0.011；夜间低血糖水平 1：IAH 132（79-209）min 与无 IAH 89（59-143）min，P=0.011；夜间低血糖水平 2：IAH 134（66-212）min 与无 IAH 80（37-131）min，P=0.002]之间存在显著差异。数据显示为中位数（四分位距）。
达到低血糖后进行扫描的时间可能是 IAH 的客观评估工具，但需要在未来的研究中进行全面调查。
