{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T04:02:00Z","timestamp":1773288120242,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T00:00:00Z","timestamp":1693785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>We aim to compare and correlate Gold and Clarke questionnaire scores with hypoglycaemic symptomatic responses between insulin\u2010treated type 2 diabetes participants with and without IAH in a real\u2010life study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Insulin\u2010treated type 2 diabetes participants attending an outpatient diabetes clinic in Singapore were asked to complete the Gold and Clarke questionnaires, record capillary blood glucose (CBG) and hypoglycaemic symptoms for 4\u2009weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data were collected from 153 participants (M:F\u2009=\u200998:55) with mean age 61.0\u2009\u00b1\u20099.4\u2009years, duration of diabetes 19.5\u2009\u00b1\u20098.8\u2009years and HbA<jats:sub>1c<\/jats:sub> 68\u2009\u00b1\u200917\u2009mmol\/mol (8.4\u2009\u00b1\u20091.5%). Gold and Clarke methods classified 19.6% and 26.8% of participants with IAH, respectively. Using CBG threshold of &lt;3\u2009mmol\/L, significantly greater proportion of participants with intact awareness were experiencing autonomic symptoms than those with IAH with either method (Gold: 69% vs. 18%, <jats:italic>p<\/jats:italic>\u2009=\u20090.006; Clarke: 85% vs. 46%, <jats:italic>p<\/jats:italic>\u2009=\u20090.010). Significantly greater proportion of participants with IAH experienced no hypoglycaemia symptoms than those with intact awareness (Gold: 3.4% vs. 36%, <jats:italic>p<\/jats:italic>\u2009=\u20090.015; Clarke: 3.7% vs. 31%, <jats:italic>p<\/jats:italic>\u2009=\u20090.031). Participants with IAH had significantly higher rates of severe hypoglycaemia in the preceding year compared to those without (Gold: 17% vs. 3.3%; Clarke: 15% vs. 2.7%, <jats:italic>p<\/jats:italic>\u2009=\u20090.012).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Gold and Clarke questionnaires are appropriate tools in ascertaining IAH status in insulin\u2010treated type 2 diabetes participants. This is the first time whereby the hypoglycaemia symptomology has robustly validated the Gold and Clarke questionnaire in insulin\u2010treated type 2 diabetes participants.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.15215","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T03:06:27Z","timestamp":1693278387000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A <scp>real\u2010life<\/scp> comparison of hypoglycaemia symptomatology between insulin\u2010treated type 2 diabetes participants with and without impaired awareness of hypoglycaemia"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9149-7347","authenticated-orcid":false,"given":"Wai Kit","family":"Lee","sequence":"first","affiliation":[{"name":"Academic Clinical Program, Division of Medicine Singapore General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle Shi Min","family":"Ko","sequence":"additional","affiliation":[{"name":"MD Programme, Duke\u2010NUS Medical School  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li Chang","family":"Ang","sequence":"additional","affiliation":[{"name":"Academic Clinical Program, Division of Medicine Singapore General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Singapore General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong Mong","family":"Bee","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Singapore General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su Yen","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Singapore General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming Ming","family":"Teh","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Singapore General Hospital  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(16)00618-8"},{"key":"e_1_2_11_3_1","volume-title":"IDF Diabetes Atlas","year":"2017"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1520-7560(199901\/02)15:1<42::AID-DMRR1>3.0.CO;2-B"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-2480"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2018.1528213"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1262-3636(10)70470-5"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.54.12.3592"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.1991.260.1.E67"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/db08-1230"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/diab.37.7.901"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.51.3.724"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2017.07.031"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13588"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-020-0518-5"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1932296815581052"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.2337\/diab.43.12.1426"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.17.7.697"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.18.4.517"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(00)04405-6"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2009.10.013"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/2042018817707422"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.4158\/ep-2018-0527"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2005.04054.x"},{"key":"e_1_2_11_26_1","unstructured":"National Glycohemoglobin Standardization Program \u2010 Certified Methods and Laboratories.National Glycohemoglobin Standardization Program.2020."},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-2361"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00401150"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.2337\/diab.42.12.1791"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2019-000935"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-019-0978-y"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.11622\/smedj.2019081"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2008.02413.x"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2021-002288"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-021-01418-z"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.15215","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T12:20:59Z","timestamp":1697545259000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.15215"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,4]]},"references-count":34,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1111\/dme.15215"],"URL":"https:\/\/doi.org\/10.1111\/dme.15215","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,4]]},"assertion":[{"value":"2023-04-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e15215"}}