Frequency of symptomatic and asymptomatic hypoglycaemia in @entity164 1 XXXX : effect of impaired awareness of hypoglycaemia.

@entity1 @entity413 @entity164 @entity6
AIMS: To characterize the frequency and the nature (symptomatic vs. asymptomatic) of hypoglycaemia in @entity1 with @entity164 1 @entity6 with impaired awareness of hypoglycaemia. METHODS: A group of 19 @entity1 with @entity164 1 @entity6 with normal hypoglycaemia awareness were matched for age, sex, duration of @entity6 and glycaemic control with 19 @entity1 with impaired awareness of hypoglycaemia. Frequency of severe hypoglycaemia in the preceding year was estimated retrospectively. Capillary blood @entity413 was monitored prospectively four times daily, over a 4-week period. All blood @entity413 values < 3 mmol/l were recorded and classified by symptom response. RESULTS: The @entity1 with impaired awareness of hypoglycaemia exhibited twice the frequency of all episodes of hypoglycaemia over the 4-week monitoring period than those with normal awareness (mean   sd 7.9    5.4 vs. 3.7    3.6, P =   0.003). No differences between the two subgroups were observed in the total number of symptomatic hypoglycaemia episodes (4.2    3.3 vs. 3.2    3.4, P = 0.25). The group with impaired awareness of hypoglycaemia had a sevenfold higher incidence of asymptomatic hypoglycaemia than those with normal awareness (3.7    5.3 vs. 0.5    1.2, P = 0.001); these episodes comprised 47% of all @entity413 values < 3.0 mmol/l in this group, compared with 14% in the normal awareness group. The annual prevalence of severe hypoglycaemia for @entity1 with impaired awareness of hypoglycaemia was 53% compared with 5% for @entity1 with normal awareness, and these @entity1 had a significantly higher incidence of severe events (1.6    2.8 vs. 0.1    0.3, P = 0.001). CONCLUSIONS: Adults with @entity164 1 @entity6 who have impaired awareness of hypoglycaemia are exposed to a much higher incidence of asymptomatic hypoglycaemia than those with normal awareness and are at higher risk of developing severe hypoglycaemia.
