INTRODUCTION
The Diabetes Control and Complications trial (DCCT) has clearly demonstrated that in people with Type 1 Diabetes (T1D), good glycaemic control leads to decreased risk of diabetes-related complications1. However, hypoglycaemia and impaired awareness of hypoglycaemia (IAH) are important barriers to optimization of glycaemic control.
Hypoglycaemia is defined as an episode of abnormally low plasma glucose that exposes the individual to potential harm2. Hypoglycaemia can be classified into three levels: a hypoglycaemia alert value (glucose =< 3.9 mmol/L), clinically significant hypoglycaemia (glucose < 3 mmol/L) and severe hypoglycaemia, which is hypoglycaemia associated with severe cognitive impairment requiring external assistance for recovery3. Impaired awareness of hypoglycaemia (IAH) is defined as a diminished ability to perceive the onset of hypoglycaemia4. IAH is an important clinical problem in people with T1D which leads to increased risk of severe hypoglycaemia (SH), increased morbidity and mortality and decreased quality of life5–9.
Despite this, there have been no prior studies on IAH done in T1D patients in Singapore. We aimed to assess the prevalence of IAH in Singapore, including its frequency, impact and association with diabetes self-management practices, in T1D patients. We also aimed to evaluate the use of the Gold and Clarke scores, both of which can be routinely administered in clinical practice, for assessment of IAH.