Observational studyBMJ open diabetes research & care2020
High prevalence of impaired awareness of hypoglycemia and severe hypoglycemia among people with insulin-treated type 2 diabetes: The Dutch Diabetes Pearl Cohort.
Observational study in BMJ open diabetes research & care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- Prevalence and contributing factors of impaired awareness of hypoglycemia in patients with type 2 diabetes: a meta-analysis.Acta diabetologica · 2023Pooled it
- One Week Exposure to a Somatostatin Receptor 2 Antagonist (SSTR2a) Enhances Glucagon Counterregulation to Insulin-Induced Hypoglycaemia and Does Not Worsen Glycemia in a Male Rat Model of Insulin-Requiring Type 2 Diabetes.Diabetes, obesity & metabolism · 2026Article
- Gold and Clarke Questionnaires Identify Different People With Insulin-Treated Diabetes and Impaired Awareness of Hypoglycaemia in Almost 60% of Cases: A Post Hoc Analysis From the Hypo-METRICS Study.Diabetes, obesity & metabolism · 2026Article
- A multicenter prospective evaluation of the benefits of Dexcom ONE + in subjects with type 2 diabetes on insulin therapy beyond glycemic control: results from the LIFE-ONE study.Acta diabetologica · 2026Article
- Associations between impaired awareness of hypoglycaemia and mental health in insulin-treated type 2 and type 1 diabetes in the Hypo-METRICS study.Diabetic medicine : a journal of the British Diabetic Association · 2026Observational
- Prolonged Somatostatin Receptor 2 Antagonism Enhances Glucagon Response to Hypoglycemia in Male Diabetic Rats.Endocrinology · 2026Article
- Construction of a Risk Prediction Model and Associative Path Analysis for Impaired Awareness of Hypoglycemia in People with Diabetes.Diabetes, metabolic syndrome and obesity : targets and therapy · 2026Article
- Impaired awareness of hypoglycemia: can structured education address this persistent challenge?Frontiers in endocrinology · 2026Review
- Factors associated with impaired hypoglycemia awareness in patients with type 2 diabetes in Korea: a cross-sectional study.Journal of Korean biological nursing science · 2025Article
- Review
- The challenge of assessing impaired awareness of hypoglycaemia in diabetes in the era of continuous glucose monitoring: A narrative review of evidence and translation into clinical practice.Diabetes, obesity & metabolism · 2025Review
- Characterising impaired awareness of hypoglycaemia and associated risks through HypoA-Q: findings from a T1D Exchange cohort.Diabetologia · 2025Article
- The Development of an Assessment Instrument for Behavior Toward Hypoglycemia Risk Among Type 2 Diabetes Mellitus Outpatients in Jakarta, Indonesia.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2025Article
- Article
- Relationship Between Sensor-Detected Hypoglycemia and Patient-Reported Hypoglycemia in People With Type 1 and Insulin-Treated Type 2 Diabetes: The Hypo-METRICS Study.Diabetes care · 2024Article
- Screening for Hypoglycaemia Risk and Medication Changes in Diabetes Patients Using Pharmacy Dispensing Data.Journal of clinical medicine · 2024Article
- Effect of Diabetes Education on Complications and Diabetic Control Amongst Adult Patients with Diabetes in Madinah, Saudi Arabia.Healthcare (Basel, Switzerland) · 2024Article
- Attitudes and practices related to hypoglycemia unawareness in patients with type 1 and type 2 diabetes.Journal of medicine and life · 2024Article
- Long-Term Sulfonylurea Use and Impaired Awareness of Hypoglycemia Among Patients With Type 2 Diabetes in Taiwan.Annals of family medicine · 2024Article
- Essential New Complexity-Based Themes for Patient-Centered Diagnosis and Treatment of Dementia and Predementia in Older People: Multimorbidity and Multilevel Phenomenology.Journal of clinical medicine · 2024Review
Corrections and comments
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Authors and funding
18 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePeople with type 2 diabetes on insulin are at risk for hypoglycemia. Recurrent hypoglycemia can cause impaired awareness of hypoglycemia (IAH), and increase the risk for severe hypoglycemia. The aim of this study was to assess the prevalence and determinants of self-reported IAH and severe hypoglycemia in a Dutch nationwide cohort of people with insulin-treated type 2 diabetes. RESEARCH DESIGN AND
methodsObservational study of The Dutch Diabetes Pearl, a cohort of people with type 2 diabetes treated in primary, secondary and tertiary diabetes care centers. The presence of IAH and the occurrence of severe hypoglycemia in the past year, defined as an event requiring external help to recover, were assessed using the validated Dutch version of the Clarke questionnaire. In addition, clinical variables were collected including age, diabetes duration, hemoglobin A1c, ethnicity and education.
results2350 people with type 2 diabetes on insulin were included: 59.1% men, mean age 61.1±10.4 years, mean diabetes duration 14.8±9.2 years and 79.5% on basal-bolus therapy. A total of 229 patients (9.7%) were classified as having IAH and 742 patients (31.6%) reported severe hypoglycemia. Increased odds for IAH were found with complex insulin regimens and lower odds with having a partner and body mass index ≥30 kg/m
conclusionsIn this nationwide cohort, almost one out of ten people with type 2 diabetes on insulin had IAH and >30% had a history of severe hypoglycemia in the past year.
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