Introduction & Objective: To determine if different SH definition wording result in different measured SH prevalence and incidence.

Methods: T1D Exchange registrants were surveyed cross-sectionally to collect 6-month SH history with definitions worded from (1) the International Hypoglycemia Study Group (IHSG) 2013 consensus; (2) a large diabetes community website (diabetes.co.uk); (3) a hypoglycemia awareness assessing instrument (HypoA-Q); and (4) the IHSG 2017 consensus. Analyses included McNemar test, kappa statistic, pair-wise Wilcoxon signed-rank test and Spearman correlation coefficient calculation.

Results: 1,580 participants (52% women, median[IQR] age 43[33—58]y, diabetes duration 24[12—37]y, 87% non-Hispanic Caucasian) completed the survey. SH prevalence with the 2013 IHSG definition wording was higher than the website, HypoA-Q and 2017 IHSG definition wording (Figure), with pairwise kappas ranging from fair to good (website definition .75; HypoA-Q .72; the 2017 IHSG definition .69). Compared to the 2013 IHSG definition wording, the website, HypoA-Q and 2017 IHSG definition wording yielded lower incidence. The 2013 IHSG definition wording correlated strongly with the website (rs=.73), HypoA-Q (rs=.72) and moderately with the 2017 IHSG definition wording (rs=.61) (P<.001 for all).

Conclusion: Reported SH prevalence and incidence vary based on definition wording.

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Disclosure

Y. Lin: None. W. Ye: None. E. Hepworth: None. L. Ang: None. N. de Zoysa: None. S.A. Amiel: Advisory Panel; Vertex Pharmaceuticals Incorporated. Other Relationship; Sanofi. S.J. Fisher: None.

Funding

National Institutes of Health (U01DK135111, K23DK129724)

© 2024 by the American Diabetes Association
2024
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