Houssein Madar1, Zekai Wu1,2, Aude Bandini3, Bruce Perkins4, Virginie Messier1, Marie-Pascale Pomey5,6, Anne-Sophie Brazeau1,7,8, Rémi Rabasa-Lhoret9,10,11,12,13. 1. Montreal Clinical Research Institute (IRCM), 110 Av. des Pins, Montreal, QC, H2W 1R7, Canada. 2. Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, QC, Canada. 3. Department of Philosophy, Faculty of Arts and Sciences, Université de Montréal, Montreal, QC, Canada. 4. Division of Endocrinology, Leadership Sinai Center for Diabetes, University of Toronto, Toronto, ON, Canada. 5. Department of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montreal, QC, Canada. 6. Endocrinology Division and CHUM Research Center, Centre Hospitalier de L'Université de Montréal (CHUM), Montreal, QC, Canada. 7. School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC, Canada. 8. Montreal Diabetes Research Center (MDRC), Montreal, QC, Canada. 9. Montreal Clinical Research Institute (IRCM), 110 Av. des Pins, Montreal, QC, H2W 1R7, Canada. remi.rabasa-lhoret@ircm.qc.ca. 10. Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, QC, Canada. remi.rabasa-lhoret@ircm.qc.ca. 11. Endocrinology Division and CHUM Research Center, Centre Hospitalier de L'Université de Montréal (CHUM), Montreal, QC, Canada. remi.rabasa-lhoret@ircm.qc.ca. 12. Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada. remi.rabasa-lhoret@ircm.qc.ca. 13. Montreal Diabetes Research Center (MDRC), Montreal, QC, Canada. remi.rabasa-lhoret@ircm.qc.ca.
Abstract
AIMS: Compare the self-reported prevalence of severe hypoglycemia (level-3-H) in people with type 1 diabetes (PWT1D) according to two wording of definition: by the International Hypoglycemia Study Group (IHSG) and an alternate simplified version developed by patient-partners (PP). METHODS: Cross-sectional study (PWT1D > = 14 years) self-reporting risk factors, patient-year incidence and annual prevalence of level-3-H were defined according to either IHSG's wording (low sugar levels requiring help from another person, or use of glucagon, or hospitalization, or loss of consciousness) or with an alternative simpler wording developed by PP (low sugar levels that you would have been unable to treat). RESULTS: Among 1430 eligible participants, in the last 12 months, the annual prevalence of level-3-H (IHSG: 242/100 vs. PP: 231/100 patient-years, p = 0.229) and median number of episodes (IHSG: 2.0 [1-3] vs. PP: 1.0 [1-3], p = 0.359) were similar. The prevalence of participants reporting hypoglycemia in the past year was higher with IHSG wording (13.5% vs. 10.5%; p < 0.001); this difference was significantly (p < 0.001) larger among patients with impaired awareness of hypoglycemia. Association of both definitions with level-3-H risk factors was comparable. CONCLUSIONS: The level-3-H episodes by PP and IHSG wording were comparable. The simplicity of PP wording may allow better mutual understanding between patients and healthcare team. TRIAL REGISTRATION: NCT03720197 (registered on October 19th 2018).
AIMS: Compare the self-reported prevalence of severe hypoglycemia (level-3-H) in people with type 1 diabetes (PWT1D) according to two wording of definition: by the International Hypoglycemia Study Group (IHSG) and an alternate simplified version developed by patient-partners (PP). METHODS: Cross-sectional study (PWT1D > = 14 years) self-reporting risk factors, patient-year incidence and annual prevalence of level-3-H were defined according to either IHSG's wording (low sugar levels requiring help from another person, or use of glucagon, or hospitalization, or loss of consciousness) or with an alternative simpler wording developed by PP (low sugar levels that you would have been unable to treat). RESULTS: Among 1430 eligible participants, in the last 12 months, the annual prevalence of level-3-H (IHSG: 242/100 vs. PP: 231/100 patient-years, p = 0.229) and median number of episodes (IHSG: 2.0 [1-3] vs. PP: 1.0 [1-3], p = 0.359) were similar. The prevalence of participants reporting hypoglycemia in the past year was higher with IHSG wording (13.5% vs. 10.5%; p < 0.001); this difference was significantly (p < 0.001) larger among patients with impaired awareness of hypoglycemia. Association of both definitions with level-3-H risk factors was comparable. CONCLUSIONS: The level-3-H episodes by PP and IHSG wording were comparable. The simplicity of PP wording may allow better mutual understanding between patients and healthcare team. TRIAL REGISTRATION: NCT03720197 (registered on October 19th 2018).
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