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PubMed · 42115542

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.

Vaios Koutroukas·Jonah Thomas·Gilberte Martine-Edith·Aikaterina Tziannou·Patrick Divilly·Uffe Søholm·Claire L Meek·Simon Heller·Julia K Mader·Ulrik Pedersen-Bjergaard·Bastiaan E de Galan·Eric Renard·Mark L Evans·Rory J McCrimmon·Jane Speight·Frans Pouwer·Stephanie A Amiel·Pratik Choudhary·Hypo‐RESOLVE consortium
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Abstract

AIMS: Gold and Clarke questionnaires are used to identify impaired awareness of hypoglycaemia (IAH) and severe hypoglycaemic event (SHE) risk in people with diabetes (pwD). We explored their overlap, including Clarke's Hypoglycaemia Awareness Status (Clarke-HAS) subfactor, and subsection differences in SHE incidence (Gold, Clarke, overlap). MATERIALS AND METHODS: This post hoc analysis of the Hypo-METRICS study recruited pwD on insulin (type 1: T1D; type 2: T2D) with &#x2265;&#x2009;1 hypoglycaemic event in the previous 3 months. IAH was defined as Gold &#x2265;&#x2009;4, Clarke &#x2265;&#x2009;4, Clarke-HAS &#x2265;&#x2009;2. RESULTS: Gold and Clarke were completed by 232 pwT1D and 285 pwT2D (age: 47 vs. 62&#x2009;years, p&#x2009;<&#x2009;0.001; HbA1c: 56&#x2009;mmol/mol (7.3%) vs. 57&#x2009;mmol/mol (7.4%), p&#x2009;=&#x2009;0.03). IAH prevalence in T1D vs. T2D was 21% vs. 26% (p&#x2009;=&#x2009;0.1), 14% vs. 18% (p&#x2009;=&#x2009;0.2), and 41% vs. 48% (p&#x2009;=&#x2009;0.2) according to Gold, Clarke and Clarke-HAS. The overlap between Gold &#x2265;&#x2009;4, Clarke &#x2265;&#x2009;4 was 40% (T1D: 45%; T2D: 37%); between Gold &#x2265;&#x2009;4, Clarke-HAS &#x2265;&#x2009;2 it was 45% (T1D: 43%; T2D: 47%). The overlap between Gold &#x2265;&#x2009;4, Clarke &#x2265;&#x2009;4 was 41% vs. 39% in CGM vs. non-CGM users (T1D: 50% vs. 35%; T2D: 32% vs. 40%); between Gold &#x2265;&#x2009;4, Clarke-HAS &#x2265;&#x2009;2 it was 39% vs. 53% (T1D: 38% vs. 54%; T2D: 40% vs. 53%). In the IAH sample, SHE rate was lower in people found with IAH by Gold vs. Clarke, 9% vs. 53%, and in those assessed by Gold-Clarke overlap vs. Clarke, 20% vs. 53% (all p&#x2009;<&#x2009;0.001). CONCLUSIONS: Gold and Clarke show moderate consistency (37%-54%) in identifying IAH in insulin-treated diabetes, with/without CGM use, each associated with different SHE rates, indicating the two questionnaires measure different, independent aspects of IAH.

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HumansHypoglycemiaFemaleMiddle AgedInsulinDiabetes Mellitus, Type 1Surveys and QuestionnairesHypoglycemic AgentsDiabetes Mellitus, Type 2AdultGlycated HemoglobinAgedAwarenessBlood GlucoseIncidencecontinuous glucose monitoring (CGM)hypoglycaemiatype 1 diabetestype 2 diabetesJournal Article

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Vaios Koutroukas, Jonah Thomas, Gilberte Martine-Edith, Aikaterina Tziannou, Patrick Divilly, Uffe S&#xf8;holm, Claire L Meek, Simon Heller, Julia K Mader, Ulrik Pedersen-Bjergaard, Bastiaan E de Galan, Eric Renard, Mark L Evans, Rory J McCrimmon, Jane Speight, Frans Pouwer, Stephanie A Amiel, Pratik Choudhary, Hypo&#x2010;RESOLVE consortium. 2026-05-11. 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.. https://doi.org/10.1111/dom.70869

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