Hypoglycemia prevalence and awareness in people with type 1 diabetes

This study investigated the prevalence of hypoglycemia (dangerously low blood glucose) and awareness of hypoglycemia in adults with type 1 diabetes (T1D). The study concluded that at least 1 in 5 adults with T1D had experienced severe hypoglycemia in the last 6 months, and/or had impaired awareness of hypoglycemia (IAH).

Severe hypoglycemia is a common complication of T1D. Recognizing the symptoms of mild hypoglycemia is important to prevent severe hypoglycemia. However, over time symptoms of hypoglycemia may change. As a result, some people experience impaired awareness of hypoglycemia (IAH). IAH is associated with an increased risk of severe hypoglycemia. It is possible that more frequent blood glucose level checks could improve awareness.

Surveys were given to 642 adults with T1D. Participants answered questions about hypoglycemia intensity and frequency. They also gave information about symptoms, IAH, and their blood-glucose-monitoring habits.

On average, the participants had had two episodes of hypoglycemia (mild or severe) in the past week. In the past 6 months 21% of participants had at least one severe hypoglycemic event. Adults who experienced at least one hypoglycemic event over the prior 6 months had lived with T1D an average of 4 years longer than the other participants.

IAH was found in 21% of participants. The rate of severe hypoglycemia was 4 times higher in adults with IAH than those with intact awareness. Those with IAH had lived with T1D an average of 7 years longer than those with intact awareness.

People with IAH still had symptoms of hypoglycemia. However, they noticed symptoms of hypoglycemia at lower glucose levels than people with intact awareness. People with IAH were more likely to check their glucose levels at least 7 times per day (26%) than those with intact awareness (15%). These patients were more likely to treat hypoglycemia at higher glucose levels than were patients who tested fewere times.

The study concluded that at least 1 in 5 adults with T1D had experienced severe hypoglycemia in the last 6 months, and/or had impaired awareness of hypoglycemia (IAH). Frequent self-monitoring of blood glucose levels led to better recognition of hypoglycemia.

If people with IAH do not check their blood glucose levels often, they may have under-reported their hypoglycemc events. All data in this study was reported by the participants, and was not measured by the researchers. Data collected in this way is not always reliable.

Discuss how symptoms of hypoglycemia change over time with your physician.