Associations Between Hypoglycemia Awareness Status and Symptoms of Hypoglycemia Among Adults with Type 1 or Insulin-Treated Type 2 Diabetes Using the Hypo-METRICS Smartphone Application.

Autor: Martine-Edith G; Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom., Zaremba N; Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom., Divilly P; Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom.; Diabetes Department, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland., Søholm U; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia., Broadley M; Department of Psychology, University of Southern Denmark, Odense, Denmark., Baumann PM; Medical University of Graz, Division of Endocrinology and Diabetology, Graz, Austria., Mahmoudi Z; Data Science, Department of Pharmacometrics, Novo Nordisk A/S, Søborg, Denmark., Gomes M; Data Science, Department of Pharmacometrics, Novo Nordisk A/S, Søborg, Denmark., Ali N; Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands., Abbink EJ; Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands., de Galan B; Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.; CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.; Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands., Brøsen J; Department of Endocrinology and Nephrology, Copenhagen University Hospital-North Zealand, Hillerød, Denmark., Pedersen-Bjergaard U; Department of Endocrinology and Nephrology, Copenhagen University Hospital-North Zealand, Hillerød, Denmark.; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Vaag AA; Steno Diabetes Center Copenhagen, Herlev, Denmark., McCrimmon RJ; Systems Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom., Renard E; Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, Montpellier, France.; Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France., Heller S; School of Medicine, University of Sheffield, Sheffield, United Kingdom., Evans M; Welcome-MRC Institute of Metabolic Science and Department of Medicine, University of Cambridge, Cambridge, United Kingdom., Cigler M; Medical University of Graz, Division of Endocrinology and Diabetology, Graz, Austria., Mader JK; Medical University of Graz, Division of Endocrinology and Diabetology, Graz, Austria., Amiel SA; Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom., Speight J; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia.; Department of Psychology, University of Southern Denmark, Odense, Denmark.; School of Psychology, Deakin University, Geelong, Australia., Pouwer F; Department of Psychology, University of Southern Denmark, Odense, Denmark.; School of Psychology, Deakin University, Geelong, Australia.; Steno Diabetes Center Odense (SDCO), Odense, Denmark., Choudhary P; Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom.; Diabetes Research Centre, University of Leicester, Leicester, United Kingdom.
Jazyk: angličtina
Zdroj: Diabetes technology & therapeutics [Diabetes Technol Ther] 2024 Aug; Vol. 26 (8), pp. 566-574. Date of Electronic Publication: 2024 Apr 12.
DOI: 10.1089/dia.2023.0596
Abstrakt: Introduction: This study examined associations between hypoglycemia awareness status and hypoglycemia symptoms reported in real-time using the novel Hypoglycaemia-MEasurement, ThResholds and ImpaCtS (Hypo-METRICS) smartphone application (app) among adults with insulin-treated type 1 (T1D) or type 2 diabetes (T2D). Methods: Adults who experienced at least one hypoglycemic episode in the previous 3 months were recruited to the Hypo-METRICS study. They prospectively reported hypoglycemia episodes using the app for 10 weeks. Any of eight hypoglycemia symptoms were considered present if intensity was rated between "A little bit" to "Very much" and absent if rated "Not at all." Associations between hypoglycemia awareness (as defined by Gold score) and hypoglycemia symptoms were modeled using mixed-effects binary logistic regression, adjusting for glucose monitoring method and diabetes duration. Results: Of 531 participants (48% T1D, 52% T2D), 45% were women, 91% white, and 59% used Flash or continuous glucose monitoring. Impaired awareness of hypoglycemia (IAH) was associated with lower odds of reporting autonomic symptoms than normal awareness of hypoglycemia (NAH) (T1D odds ratio [OR] 0.43 [95% confidence interval {CI} 0.25-0.73], P  = 0.002); T2D OR 0.51 [95% CI 0.26-0.99], P  = 0.048), with no differences in neuroglycopenic symptoms. In T1D, relative to NAH, IAH was associated with higher odds of reporting autonomic symptoms at a glucose concentration <54 than >70 mg/dL (OR 2.18 [95% CI 1.21-3.94], P  = 0.010). Conclusion: The Hypo-METRICS app is sensitive to differences in hypoglycemia symptoms according to hypoglycemia awareness in both diabetes types. Given its high ecological validity and low recall bias, the app may be a useful tool in research and clinical settings. The clinical trial registration number is NCT04304963.
Databáze: MEDLINE
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