Symptomatic Hypoglycaemia in 411 Type 1 Diabetic Patients

TLDR

The study prospectively recorded symptomatic hypoglycaemic episodes in 411 randomly selected conventionally treated type 1 diabetic out‑patients by having patients complete home questionnaires between clinic visits and maintain a one‑week diary. In this cohort, symptomatic hypoglycaemia occurred on average 1.7–1.8 mild and 0.03–0.03 severe episodes per patient per week, was more common on weekdays and in the morning, and 36 % of patients had experienced a hypoglycaemic coma, with only weak correlations to insulin dose, age, HbA1c, and other factors.

Abstract

The frequency of symptomatic hypoglycaemic episodes was studied in 411 randomly selected conventionally treated Type 1 diabetic out‐patients. Between two consecutive visits to the out‐patient clinic each patient filled in a questionnaire at home. The number of hypoglycaemic episodes was then recorded prospectively in a diary for 1 week. From the questionnaires, the (retrospective) frequencies of mild and severe symptomatic hypoglycaemia were 1.6 and 0.029 episodes patient −1 week −1 . From the diaries, the (prospective) frequencies of mild and severe hypoglycaemic episodes were 1.8 and 0.027 patient −1 week −1 . Symptomatic hypoglycaemia was more frequent on working days than during weekends (1.8:1) and more frequent in the morning than during the afternoon, evening, and night (4.5:2.2:1.4:1). The symptoms of hypoglycaemia were non‐specific, heterogeneous, and weakened with increasing duration of diabetes. During their diabetic life, 36 % of the patients had experienced hypoglycaemic coma. The frequency of hypoglycaemia was positively, but only weakly, correlated with insulin dose, number of injections, percentage unmodified insulin of the total dose, and HbA 1c (mild hypoglycaemia only). The frequency was also negatively, but weakly, correlated with age and HbA 1c (episodes with coma only), but not correlated with sex, duration of diabetes, or patients' ratings of worries about mild and severe hypoglycaemia.