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Cited by 287Diabetes Management and ResearchDiabetes Treatment and ManagementDiabetes Management and Education

Hypoglycaemia in insulin‐treated Type 2 diabetes: frequency, symptoms and impaired awareness

Henderson, J. N., Allen, K. V., Deary, I. J., Frier, B. M.·2003·Diabetic Medicine
DOI 10.1046/j.1464-5491.2003.01072.x
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Abstract

Aims Hypoglycaemia is considered to be less common in people with insulin‐treated Type 2 diabetes than in Type 1 diabetes. A retrospective survey was made of 215 people with insulin‐treated Type 2 diabetes to quantify the frequency and nature of hypoglycaemia experienced. Methods The frequencies of mild (self‐treated) and severe (required assistance) hypoglycaemia during the preceding year were estimated retrospectively. The usual symptoms of hypoglycaemia and state of awareness of hypoglycaemia were scored using validated questionnaires and any history suggestive of impaired hypoglycaemia awareness was documented. Results In this cohort, 157 (73%) had experienced hypoglycaemia since commencing insulin, the frequency of which increased with duration of diabetes and of insulin therapy and was inversely related to current HbA 1c (all P < 0.05). During the preceding year, 32 individuals (15%) had experienced severe hypoglycaemia, with an estimated incidence for the entire group of 0.28 episodes/patient/year. Principal components analysis revealed two underlying symptom groups (autonomic and neuroglycopenic), similar to those reported previously by young adults with Type 1 diabetes, but the total symptom score declined with advancing age. Of the 157 with a history of hypoglycaemia, the 13 (8%) individuals who gave a history of impaired awareness of hypoglycaemia had experienced a ninefold higher incidence of severe hypoglycaemia than those with normal awareness, and reported experiencing mainly neuroglycopenic symptoms. Conclusions While the overall frequencies of mild and severe hypoglycaemia were lower in insulin‐treated Type 2 diabetes than have been reported previously in Type 1 diabetes, the risk of hypoglycaemia was greater with increasing duration of diabetes and of insulin therapy. Although impaired awareness of hypoglycaemia was uncommon, it was associated with a higher incidence of severe hypoglycaemia. Diabet. Med. 20, ***–*** (2003)

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  • In a retrospective survey of 215 individuals with insulin-treated type 2 diabetes, only 8% had impaired awareness estimated by a validated scoring system, but those so affected had a ninefold greater incidence of hypoglycemia than those with intact awareness.

    “One retrospective survey of 215 individuals with insulin-treated type 2 diabetes showed that only 8% had impaired awareness estimated by a validated scoring system (70), but those so affected had a ninefold greater incidence of hypoglycemia than those with intact awareness (82).”

    From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [82]

  • In that survey, the annual prevalence of severe hypoglycemia was 15% with an overall incidence of 0.28 episodes per patient per year.

    “The annual prevalence of severe hypoglycemia was 15% with an overall incidence of 0.28 episodes per patient per year.”

    From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [82]

  • In a retrospective Scottish survey in Edinburgh of 215 people with insulin-treated type 2 diabetes, the frequency of hypoglycemia increased with duration of insulin therapy and of diabetes and was inversely proportional to HbA1c concentration.

    “A retrospective Scottish survey in Edinburgh of 215 people with insulintreated type 2 diabetes observed that the frequency of hypoglycemia increased with duration of insulin therapy and of diabetes and was inversely proportional to HbA 1c (A1C) concentration (82).”

    From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [82]

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Authors
Henderson, J. N., Allen, K. V., Deary, I. J., & Frier, B. M.
Affiliations
  • Edinburgh Royal Infirmary (GB)
  • University of Edinburgh (GB)
Corresponding author
Frier, B. M.
ORCID
Venue
Diabetic Medicine
Publisher
Wiley
Published
2003-11-24
Volume
20
Issue
12
Pages
1016-1021
ISSN
  • 0742-3071 (ISSN-L)
  • 1464-5491
DOI
10.1046/j.1464-5491.2003.01072.x
OpenAlex
W2150540429
Cited by
287
References
24
Citations by year
2026: 6 · 2025: 5 · 2024: 8 · 2023: 11 · 2022: 11 · 2021: 10 · 2020: 11 · 2019: 10 · 2018: 19 · 2017: 13 · 2016: 13 · 2015: 18 · 2014: 21 · 2013: 19 · 2012: 16
FWCI
5.20
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Diabetic Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
Royal Society of Edinburgh
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords
hypoglycemia, type 2 diabetes, insulin therapy, severe hypoglycemia, neuroglycopenic symptoms, autonomic symptoms, hypoglycaemia incidence, HbA1c, diabetes duration, age
MeSH terms
Adult, Aged, Aged, 80 and over, Aging, Autonomic Nervous System, Awareness, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Hypoglycemia, Insulin, Male, Middle Aged, Nervous System Diseases, Retrospective Studies, Time Factors, Principal Component Analysis

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