Background: Precision medicine in diabetes care requires a dedicated focus on hypoglycemic symptoms. This study aimed to explore the interrelationship between the clustering of hypoglycemic symptoms, psychological characteristics, and problem-solving capabilities in adults with type 1 diabetes (T1D).
Methods: A total of 251 adults with T1D (mean age: 51.5±12.9 years, mean HbA1c: 7.7 ± 0.9%) participated in this survey. Hierarchical clustering was employed to analyze eleven hypoglycemic symptoms (Edinburgh). Data encompassed diabetic complications, fear of hypoglycemia (HFS-behaviour and HFS-worry), depressive symptoms (PHQ-9), the hypoglycemia problem-solving scale (HPSS), and treatment details.
Results: Three distinct clusters emerged: individuals not sensitive to autonomic and neuroglycopenic symptoms (cluster 1, n=138), those sensitive to both autonomic and neuroglycopenic symptoms (cluster 2, n=19), and those sensitive to autonomic but not to neuroglycopenic symptoms (cluster 3, n=94). Compared to cluster 1, clusters 2 and 3 exhibited younger ages, higher fear of hypoglycemia, increased depressive symptoms, and greater use of CSII. Cluster 2 also displayed enhanced HPSS scores, indicating better detection control and a more proactive approach to seeking preventive strategies compared to cluster 1. No significant differences were observed in terms of diabetes duration, BMI, HbA1c levels, or diabetic complications. However, certain lifestyle factors, such as breakfast skipping, snack and sweetened beverage intake, and sleep deficits, varied among the clusters.
Conclusion: This study identifies three distinct clusters among adults with T1D. The findings may serve as valuable insights for diabetes professionals seeking to educate these individuals on how to effectively manage hypoglycemia.
N. Sakane: None. S. Sakane: None.
