PP19 A study of the prevalence of impaired awareness of hypoglycaemia in people who have had a severe hypoglycaemic emergency and been attended by the ambulance service

Background

Severe hypoglycaemia is a serious condition and accounts for 0.6%–1.0% of all UK emergency ambulance calls per annum. Our previous qualitative research suggested that many Diabetes related hypoglycaemia patients attended by the ambulance service experienced impaired awareness of hypoglycaemia (IAH), a treatable condition which reduces patients' awareness of the signs and symptoms of an impending severe hypoglycaemic emergency. The prevalence of IAH among people with type 1 Diabetes is approximately 25%. In type 2 its prevalence is approximately 10%. However the prevalence of IAH in people who use the ambulance service due to a hypoglycaemic emergency was unknown. Our aim therefore was to investigate the prevalence of IAH in patients who require ambulance service attendance due to severe hypoglycaemia.

Methods

We undertook a national cross-sectional survey of the prevalence of IAH. An a priori target sample size of 415 was set to allow estimation of proportions of IAH within a 5% margin of error (99% CI). From January–June 2016, patients (>16 years) attended by the Scottish Ambulance Service due a Diabetes related emergency with a blood glucose <4 mmol/L were identified as potential participants. A questionnaire with two standardised IAH measures (Gold et al. and Clarke et al) was posted to potential participants within a month of their severe hypoglycaemic event. Consent to participate was assumed through questionnaire return. Ethical approval was received from the National Research Ethics Service (15/EE/0383).

Results

Five hundred and ninety-two questionnaires were returned. The prevalence of impaired awareness of hypoglycaemia in among participants as measured using the two standardised measures was 53% and 57% respectively.

Conclusion

IAH is considerably more prevalent among people who have a severe hypoglycaemic emergency and call the ambulance service than in the general Diabetic population. This knowledge will assist in the development of an intervention to reduce hypoglycaemic emergencies and may lead to improved outcomes and cost savings.

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