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Sakane N, Kato K, Hata S, Nishimura E, Araki R, Kouyama K, Hatao M, Matoba Y, Matsushita Y, Domichi M, Suganuma A, Sakane S, Murata T, Wu FL. Protective and risk factors of impaired awareness of hypoglycemia in patients with type 1 diabetes: a cross-sectional analysis of baseline data from the PR-IAH study. Diabetol Metab Syndr 2023; 15:79. [PMID: 37095537 PMCID: PMC10127054 DOI: 10.1186/s13098-023-01024-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 03/11/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Hypoglycemia in type 1 diabetes (T1D) is associated with mortality and morbidity, especially when awareness of hypoglycemia is impaired. This study aimed to investigate the protective and risk factors for impaired awareness of hypoglycemia (IAH) in adults with T1D. METHODS This cross-sectional study enrolled 288 adults with T1D (mean age, 50.4 ± 14.6 years; male, 36.5%; diabetes duration, 17.6 ± 11.2 years; mean HbA1c level, 7.7 ± 0.9%), who were divided into IAH and non-IAH (control) groups. A survey was conducted to assess hypoglycemia awareness using the Clarke questionnaire. Diabetes histories, complications, fear of hypoglycemia, diabetes distress, hypoglycemia problem-solving abilities, and treatment data were collected. RESULTS The prevalence of IAH was 19.1%. Diabetic peripheral neuropathy was associated with an increased risk of IAH (odds ratio [OR] 2.63; 95% confidence interval [CI] 1.13-5.91; P = 0.014), while treatment with continuous subcutaneous insulin infusion and hypoglycemia problem-solving perception scores were associated with a decreased risk of IAH (OR, 0.48; 95% CI, 0.22-0.96; P = 0.030; and OR, 0.54; 95% CI, 0.37-0.78; P = 0.001, respectively). There was no difference in continuous glucose monitoring use between the groups. CONCLUSION We identified protective factors in addition to risk factors for IAH in adults with T1D. This information may help manage problematic hypoglycemia. TRIAL REGISTRATION University hospital Medical Information Network (UMIN) Center: UMIN000039475). Approval date 13 February 2020.
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Affiliation(s)
- Naoki Sakane
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, 612-8555, Kyoto, Japan.
| | - Ken Kato
- Diabetes center, National Hospital Organization Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, 540-0006, Osaka, Japan
| | - Sonyun Hata
- Diabetes center, National Hospital Organization Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, 540-0006, Osaka, Japan
| | - Erika Nishimura
- Diabetes center, National Hospital Organization Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, 540-0006, Osaka, Japan
| | - Rika Araki
- Department of Diabetes and Endocrinology, National Hospital Organization Mie National Hospital, 357 Ozatokubota-cho, 514-0125, Tsu, Mie, Japan
| | - Kunichi Kouyama
- Department of Diabetes and Metabolism, National Hospital Organization Hyogo-Chuo National Hospital, 1314Ohara, 669-1515, Sanda, Hyogo, Japan
| | - Masako Hatao
- Department of Diabetes and Endocrinology, National Hospital Organization Himeji Medical Center, 68 Honmachi, 670-0012, Himeji, Hyogo, Japan
| | - Yuka Matoba
- Department of Diabetes, Endocrinology and Metabolism, National Hospital Organization Kokura Medical Center, 10-1 Harugaoka, Kitakyushu Kokuraminami-ku, 802-0803, Fukuoka, Japan
| | - Yuichi Matsushita
- Department of Diabetology and Metabolism, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Okayama Kita-ku, 701-1192, Okayama, Japan
| | - Masayuki Domichi
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, 612-8555, Kyoto, Japan
| | - Akiko Suganuma
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, 612-8555, Kyoto, Japan
| | - Seiko Sakane
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, 612-8555, Kyoto, Japan
| | - Takashi Murata
- Department of Clinical Nutrition, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, 612-8555, Kyoto, Japan
- Diabetes Center, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, 612-8555, Kyoto, Japan
| | - Fei Ling Wu
- Department of Nursing, Chang Gung University of Science and Technology, No. 261, Wenhua 1st Rd, Guishan District, 333, Taoyuan City, Taiwan
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Graven LJ, Abbott L, Schluck G. The coping in heart failure (COPE-HF) partnership intervention for heart failure symptoms: Implications for palliative care. PROGRESS IN PALLIATIVE CARE 2022. [DOI: 10.1080/09699260.2022.2124144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Affiliation(s)
| | - Laurie Abbott
- Florida State University College of Nursing, Tallahassee, FL, USA
| | - Glenna Schluck
- Florida State University College of Nursing, Tallahassee, FL, USA
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