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  • 1
    Online Resource
    Online Resource
    Bentham Science Publishers Ltd. ; 2019
    In:  Current Diabetes Reviews Vol. 15, No. 5 ( 2019-08-20), p. 407-413
    In: Current Diabetes Reviews, Bentham Science Publishers Ltd., Vol. 15, No. 5 ( 2019-08-20), p. 407-413
    Abstract: Patients with Type 2 Diabetes Mellitus (T2DM) may develop hypoglycemia as an adverse effect of insulin therapy. Hypoglycemia has dangerous consequences that result from neuroglycopenia and hypersecretion of counter-regulatory hormones. Patients who recognize early symptoms of hypoglycemia can initiate self-treatment and rectify the situation. Impaired Awareness of Hypoglycemia (IAH) predisposes patients to severe hypoglycemia and unconsciousness. Objective: To assess the prevalence of IAH, the intensity of hypoglycaemic symptoms, the frequency of severe hypoglycemia and factors associated with IAH in patients with insulin-treated T2DM. Methods: This is a cross-sectional study that used Clarke's and Gold's surveys to assess IAH and Edinburgh survey to assess the intensity of hypoglycemic symptoms in patients with insulin-treated T2DM (n= 388). The frequency of hypoglycemia and other data were collected by self-reporting or from medical records. Results: The prevalence (95% confidence interval) of IAH was 17.01% (13.27%-20.75%) as determined by Clarke’s method and 5.93% (3.58-8.28) by Gold’s method (Odds= 3.25, p-value 〈 0.00001). Drowsiness, hunger, sweating, tiredness, trembling and weakness, were the most intense hypoglycaemic symptoms, and 6.19% of participants reported at least one episode of severe hypoglycaemia within the past year. Regardless of classification method used, IAH is not dependent on age, gender, duration of T2DM or duration of insulin therapy (p-values 〉 0.05). Instead, IAH is positively associated with frequency of hypoglycaemia during the previous six months (p-value 〈 0.05) and development of severe hypoglycaemia within the past year (p-value 〈 0.05). Conclusion: This study highlights large variability in IAH depending on the method used for assessment. Increased hypoglycaemia frequency may increase the prevalence of IAH and thus the development of severe hypoglycemia
    Type of Medium: Online Resource
    ISSN: 1573-3998
    Language: English
    Publisher: Bentham Science Publishers Ltd.
    Publication Date: 2019
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  • 2
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2019
    In:  BMC Endocrine Disorders Vol. 19, No. 1 ( 2019-12)
    In: BMC Endocrine Disorders, Springer Science and Business Media LLC, Vol. 19, No. 1 ( 2019-12)
    Abstract: Hypoglycemia is a common complication of insulin therapy in patients with Type 1 Diabetes Mellitus (DM). Awareness of hypoglycemic symptoms helps patients to recognize hypoglycemia and initiate self-treatment. Impaired Awareness of Hypoglycemia (IAH) exposes patients to severe hypoglycemia, which could be associated with seizures and unconsciousness. This study aimed to assess IAH, frequency of hypoglycemia, severe hypoglycemia and intensity of hypoglycemic symptoms among children and adolescents with Type 1 DM in North of Jordan. Methods Data were collected from 94 children and adolescents with Type 1 DM. Clarke’s and Edinburgh surveys were used to assess IAH and individual symptoms of hypoglycemia, respectively. Frequency of hypoglycemia and other related information were obtained by self-reporting or from medical records. Results 16.0% of participants were having IAH, 66.0% of participants reported recurrent hypoglycemia ( 〉 once/month) and 18.0% of participants developed ≥1 severe hypoglycemia during the previous year. IAH was not associated with age, gender, duration of DM, HbA1c, insulin regimen, adherence to insulin or development of severe hypoglycemia ( p -values 〉  0.05). Instead, IAH was associated with frequency of hypoglycemia during the previous 6 months ( p -value 〈  0.01). Hunger, tiredness, dizziness, drowsiness, inability to concentrate, trembling and weakness were the most common symptoms felt by participants when they develop hypoglycemia. Hunger was the only common symptom that was significantly higher in children compared to adolescent ( p -value 〈  0.01). Conclusions This study has reported low prevalence of IAH in children and adolescents with Type 1 DM in North of Jordan. IAH was more common in subjects with more frequent hypoglycemia.
    Type of Medium: Online Resource
    ISSN: 1472-6823
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2091323-0
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