Burden of impaired awareness of hypoglycemia in people with diabetes undergoing hemodialysis
Introduction Impaired awareness of hypoglycemia (IAH) refers to a diminished capacity to detect hypoglycemia. IAH can result in severe and even life-threatening outcomes for individuals with diabetes, especially those in advanced stages of the disease. This study aimed to assess the prevalence of IA...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-01-01
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| Series: | BMJ Open Diabetes Research & Care |
| Online Access: | https://drc.bmj.com/content/12/1/e003730.full |
| _version_ | 1797289484524453888 |
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| author | Hellena Hailu Habte-Asres Yutong Jiang Miranda Rosenthal David Collins Wheeler |
| author_facet | Hellena Hailu Habte-Asres Yutong Jiang Miranda Rosenthal David Collins Wheeler |
| author_sort | Hellena Hailu Habte-Asres |
| collection | DOAJ |
| description | Introduction Impaired awareness of hypoglycemia (IAH) refers to a diminished capacity to detect hypoglycemia. IAH can result in severe and even life-threatening outcomes for individuals with diabetes, especially those in advanced stages of the disease. This study aimed to assess the prevalence of IAH in people with diabetes on hemodialysis.Research design and methods We conducted a single-center audit to assess the prevalence of IAH using the Clarke questionnaire. Simultaneously, we measured fear of hypoglycemia with an adapted version of the Hypoglycemia Survey and recorded the incidence of severe hypoglycemia. Data were presented as mean±SD or counts/percentages. Logistic regression was then employed to analyze the association between IAH and various sociodemographic and clinical factors.Results We included 56 participants with diabetes on hemodialysis, with a mean age of 67.2 years (±12.9), of whom 51.8% were male. The ethnic distribution was 23.2% white, 23.2% black, 19.6% Asian, and 33.9% unspecified. The mean HbA1c was 52 mmol/mol (±18.6). The majority (91.1%) had a diagnosis of type 2 diabetes, and 55.4% of those were treated with insulin. The use of diabetes technology was low, with 2.8% of the participants using a continuous glucose monitor. IAH prevalence was 23.2%, and among the 57 participants, 23.6% had a history of severe hypoglycemia, and 60.6% reported fear of hypoglycemia. There were no significant differences in sociodemographic and clinical characteristics between those with IAH and normal hypoglycemia awareness.Conclusions We observed that 23.2% of individuals with diabetes undergoing hemodialysis had IAH. IAH was more prevalent in people who reported a fear of hypoglycemia and had a history of severe hypoglycemia episode. The study highlights the unmet needs and disparities in access to diabetes technology within this population. |
| first_indexed | 2024-03-07T19:05:39Z |
| format | Article |
| id | doaj.art-c0e7959e4f7346acb9ea5a61318f242a |
| institution | Directory Open Access Journal |
| issn | 2052-4897 |
| language | English |
| last_indexed | 2024-03-07T19:05:39Z |
| publishDate | 2024-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Diabetes Research & Care |
| spelling | doaj.art-c0e7959e4f7346acb9ea5a61318f242a2024-03-01T08:50:08ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972024-01-0112110.1136/bmjdrc-2023-003730Burden of impaired awareness of hypoglycemia in people with diabetes undergoing hemodialysisHellena Hailu Habte-Asres0Yutong Jiang1Miranda Rosenthal2David Collins Wheeler3Royal Free London NHS Foundation Trust, London, UKDepartment of Nephrology, UCL, London, UKRoyal Free London NHS Foundation Trust, London, UKDepartment of Renal Medicine, UCL, London, UKIntroduction Impaired awareness of hypoglycemia (IAH) refers to a diminished capacity to detect hypoglycemia. IAH can result in severe and even life-threatening outcomes for individuals with diabetes, especially those in advanced stages of the disease. This study aimed to assess the prevalence of IAH in people with diabetes on hemodialysis.Research design and methods We conducted a single-center audit to assess the prevalence of IAH using the Clarke questionnaire. Simultaneously, we measured fear of hypoglycemia with an adapted version of the Hypoglycemia Survey and recorded the incidence of severe hypoglycemia. Data were presented as mean±SD or counts/percentages. Logistic regression was then employed to analyze the association between IAH and various sociodemographic and clinical factors.Results We included 56 participants with diabetes on hemodialysis, with a mean age of 67.2 years (±12.9), of whom 51.8% were male. The ethnic distribution was 23.2% white, 23.2% black, 19.6% Asian, and 33.9% unspecified. The mean HbA1c was 52 mmol/mol (±18.6). The majority (91.1%) had a diagnosis of type 2 diabetes, and 55.4% of those were treated with insulin. The use of diabetes technology was low, with 2.8% of the participants using a continuous glucose monitor. IAH prevalence was 23.2%, and among the 57 participants, 23.6% had a history of severe hypoglycemia, and 60.6% reported fear of hypoglycemia. There were no significant differences in sociodemographic and clinical characteristics between those with IAH and normal hypoglycemia awareness.Conclusions We observed that 23.2% of individuals with diabetes undergoing hemodialysis had IAH. IAH was more prevalent in people who reported a fear of hypoglycemia and had a history of severe hypoglycemia episode. The study highlights the unmet needs and disparities in access to diabetes technology within this population.https://drc.bmj.com/content/12/1/e003730.full |
| spellingShingle | Hellena Hailu Habte-Asres Yutong Jiang Miranda Rosenthal David Collins Wheeler Burden of impaired awareness of hypoglycemia in people with diabetes undergoing hemodialysis BMJ Open Diabetes Research & Care |
| title | Burden of impaired awareness of hypoglycemia in people with diabetes undergoing hemodialysis |
| title_full | Burden of impaired awareness of hypoglycemia in people with diabetes undergoing hemodialysis |
| title_fullStr | Burden of impaired awareness of hypoglycemia in people with diabetes undergoing hemodialysis |
| title_full_unstemmed | Burden of impaired awareness of hypoglycemia in people with diabetes undergoing hemodialysis |
| title_short | Burden of impaired awareness of hypoglycemia in people with diabetes undergoing hemodialysis |
| title_sort | burden of impaired awareness of hypoglycemia in people with diabetes undergoing hemodialysis |
| url | https://drc.bmj.com/content/12/1/e003730.full |
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