Associations between clustering of hypoglycemic symptoms, psychological traits, and problem-solving abilities in adults with type 1 diabetes: baseline data analysis of the PR-IAH study

被引：0

作者：

Sakane, Naoki ^{[1
]}

Kato, Ken ^{[2
]}

Hata, Sonyun ^{[2
]}

Nishimura, Erika ^{[2
]}

Araki, Rika ^{[3
]}

Kouyama, Kunichi ^{[4
]}

Hatao, Masako ^{[5
]}

Matoba, Yuka ^{[6
]}

Matsushita, Yuichi ^{[7
]}

Domichi, Masayuki ^{[1
]}

Suganuma, Akiko ^{[1
]}

Sakane, Seiko ^{[1
]}

Murata, Takashi ^{[8
,9
]}

Wu, Fei Ling ^{[10
]}

机构：

[1] Natl Hosp Org, Clin Res Inst, Div Prevent Med, Kyoto Med Ctr, 1-1 Mukaihata Cho,Fukakusa,Fushimi Ku, Kyoto 6128555, Japan

[2] Natl Hosp Org, Diabet Ctr, Osaka Natl Hosp, 2-1-14 Hoenzaka,Chuo Ku, Osaka 5400006, Japan

[3] Natl Hosp Org, Dept Diabet & Endocrinol, Mie Natl Hosp, 357 Ozatokubota Cho, Tsu, Mie 5140125, Japan

[4] Natl Hosp Org, Dept Diabet & Metab, Hyogo Chuo Natl Hosp, 1314Ohara, Sanda, Hyogo 6691515, Japan

[5] Natl Hosp Org, Dept Diabet & Endocrinol, Himeji Med Ctr, 68 Honmachi, Himeji, Hyogo 6708520, Japan

[6] Natl Hosp Org, Dept Diabet Endocrinol & Metab, Kokura Med Ctr, 10-1 Harugaoka,Kitakyushu,Kokuraminami Ku, Fukuoka 8020803, Japan

[7] Natl Hosp Org, Dept Diabetol & Metab, Okayama Med Ctr, 1711-1 Tamasu,Okayama Kita Ku, Okayama 7011154, Japan

[8] Natl Hosp Org, Dept Clin Nutr, Kyoto Med Ctr, 1-1 Mukaihata Cho,Fukakusa,Fushimi Ku, Kyoto 6128555, Japan

[9] Natl Hosp Org, Diabet Ctr, Kyoto Med Ctr, 1-1 Mukaihata Cho,Fukakusa,Fushimi Ku, Kyoto 6128555, Japan

[10] Chang Gung Univ Sci & Technol, Dept Nursing, 261,Wenhua 1st Rd, Taoyuan 333, Taiwan

来源：

DIABETOLOGY INTERNATIONAL | 2025年 / 16卷 / 02期

关键词：

Type; 1; diabetes; Hypoglycemic symptoms; Hypoglycemia problem-solving scale; Hierarchical clustering; Feature importance; HEALTH QUESTIONNAIRE-9 PHQ-9; IMPAIRED AWARENESS; DEPRESSION; RESPONSES; HUNGER; FEAR;

D O I：

10.1007/s13340-024-00788-5

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundPrecision medicine in diabetes care requires a dedicated focus on hypoglycemic symptoms. This study explored the associations between clustering of hypoglycemic symptoms, psychological characteristics, and problem-solving capabilities in adults with type 1 diabetes (T1D).MethodsA total of 251 adults with T1D participated in this survey. Hierarchical clustering was used to analyze 11 hypoglycemic symptoms (Edinburgh scale). The data included diabetic complications, fear of hypoglycemia, depressive symptoms, hypoglycemia problem-solving scale (HPSS), and treatment details. For predicting clusters and identifying feature importance, we utilized a machine learning approach.ResultsThree distinct clusters were observed; individuals not sensitive to autonomic or neuroglycopenic symptoms (cluster 1, n = 138), those sensitive to both autonomic and neuroglycopenic symptoms (cluster 2, n = 19), and those sensitive to autonomic but not neuroglycopenic symptoms (cluster 3, n = 94). Compared to cluster 1, individuals from clusters 2 and 3 were of younger age, had higher fear of hypoglycemia, increased depressive symptoms, and greater use of continuous subcutaneous insulin infusion. Cluster 2 displayed enhanced HPSS scores, indicating better detection control and a more proactive approach to seeking preventive strategies than cluster 1. The accuracy for classifying into 3 clusters using machine learning was 88.2%. The feature importance of random forest model indicated that hunger, shaking, palpitation, sweating, and confusion were the top five important factors for predicting clusters.ConclusionThis study identified three distinct clusters of adults with T1D. These findings may provide valuable insights for diabetes professionals seeking to educate these individuals on how to manage hypoglycemia effectively.Trial registrationUniversity Hospital Medical Information Network (UMIN) Center: UMIN000039475); approval date: February 13, 2020.

引用

页码：294 / 302

页数：9

共 41 条

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