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Cited by 286Diabetes Management and ResearchDiabetes Management and EducationPsychometric Methodologies and Testing

Partitioning the symptoms of hypoglycaemia using multi-sample confirmatory factor analysis

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Deary, I. J., Hepburn, D. A., MacLeod, K. M., Frier, B. M.·1993·Diabetologia
DOI 10.1007/bf00401150
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Abstract

The allocation of hypoglycaemic symptoms to autonomic or neuroglycopenic groups tends to occur on an a priori basis. In view of the practical need for clear symptom markers of hypoglycaemia more scientific approaches must be pursued. Substantial evidence is presented from two large scale studies we performed which support a three factor model of hypoglycaemic symptomatology, based on the statistical associations discovered among symptoms reported by diabetic patients. Study 1 involved 295 insulin-treated out-patients and found that 11 key hypoglycaemic symptoms segregated into three clear factors: autonomic (sweating, palpitation, shaking and hunger) neuroglycopenic (confusion, drowsiness, odd behaviour, speech difficulty and incoordination), and malaise (nausea and headache). The three factors were validated on a separate group of 303 insulin-treated diabetic out-patients. Confirmatory factor analyses showed that the three factor model was the optimal model for explaining symptom covariance in each group. A multi-sample confirmatory factor analysis tested the rigorous assumptions that the relative loadings of symptoms on factors across groups were equal, and that the residual variance for each symptom was identical across groups. These assumptions were successful, indicating that the three factor model was replicated in detail across these two large samples. It is suggested that the results indicate valid groupings of symptoms that may be used in future research and in clinical practice.

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  • Symptoms are generated at arterialized blood glucose concentrations around 2.8-3.2 mmol/l (50-58 mg/dl).

    “Symptoms are generated at arterialized blood glucose concentrations around 2.8 -3.2 mmol/l (50 -58 mg/dl)”

    From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [11]

  • Autonomic symptoms of hypoglycemia usually occur at higher glucose thresholds than neuroglycopenic symptoms.

    “Autonomic symptoms usually occur at higher glucose thresholds than neuroglycopenic ones [ 3 , 4 ].”

    From Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications (2024) · cites this paper as [4]

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Authors
Deary, I. J., Hepburn, D. A., MacLeod, K. M., & Frier, B. M.
Affiliations
  • University of Edinburgh (GB)
  • Edinburgh Royal Infirmary (GB)
ORCID
Venue
Diabetologia
Publisher
Springer Science and Business Media LLC
Published
1993-08
Volume
36
Issue
8
Pages
771-777
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
DOI
10.1007/bf00401150
OpenAlex
W2055179027
Cited by
286
References
27
Citations by year
2026: 6 · 2025: 9 · 2024: 15 · 2023: 17 · 2022: 7 · 2021: 13 · 2020: 15 · 2019: 14 · 2018: 10 · 2017: 8 · 2016: 12 · 2015: 9 · 2014: 8 · 2013: 12 · 2012: 5
FWCI
3.22
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Diabetologia (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Keywords
hypoglycemia, hypoglycaemic symptoms, autonomic symptoms, neuroglycopenic symptoms, malaise, symptom clustering, three-factor model, insulin-treated diabetes
MeSH terms
Adolescent, Adult, Aged, Analysis of Variance, Autonomic Nervous System, Behavior, Confusion, Diabetes Mellitus, Type 1, Headache, Heart Rate, Humans, Hunger, Hypoglycemia, Insulin, Middle Aged, Models, Biological, Nausea, Psychomotor Performance, Sleep Stages, Speech Disorders, Sweating

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