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30 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
  1. E Duncan,
  2. D Fitzpatrick,
  3. J Evans
  1. University of Stirling


Aim To investigate the prevalence of Impaired Awareness of Hypoglycaemia in patients who require ambulance service attendance due to severe hypoglycaemia.

Methods We undertook a national cross-sectional survey of the prevalence of Impaired Awareness of Hypoglycaemia (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 measures1,2 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, where prevalence is 25%.1 This knowledge will assist in the development of an intervention to reduce hypoglycaemic emergencies and may lead to improved outcomes and cost savings.


  1. Gold AE, Macleod KM, Frier BM. Frequency of severe hypoglycemia in patients with type I diabetes with impaired awareness of hypoglycemia. Diabetes Care 1994;17(7):697–703.

  2. Clarke WL, Cox DJ, Gonder-Frederick LA, Julian D, Schlundt D, Polonsky W. Reduced awareness of hypoglycemia in adults with IDDM: a prospective study of hypoglycemic frequency and associated symptoms. Diabetes Care 1995;18(4):517–522.

Conflict of interest This study was funded by the Scottish Ambulance Service who employ Dr. D Fitzpatrick. The ambulance service management had no direct involvement in the design, conduct, analysis or output arising from the study.

Funding Scottish Ambulance Service

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