Development and validation of a questionnaire evaluating impaired hypoglycemia awareness among adult Filipino patients with type 2 diabetes mellitus
- Author:
Uzziel de Mesa
1
;
Ma. Cecille Anonuevo-Cruz
1
;
Nemencio Nicodemus Jr.
2
;
Nikolai Gil Reyes
3
Author Information
- Publication Type:Journal Article
- MeSH: Diabetes Mellitus; Hypoglycemia; Surveys and Questionnaires
- From: Journal of the ASEAN Federation of Endocrine Societies 2017;32(2):158-164
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Hazards of hypoglycemia include accidents, cardiovascular events, neurologic damage, and impaired hypoglycemia awareness (IHA) which presents as inability to perceive and respond to hypoglycemic warning symptoms.
Objective:This study aimed to develop the first questionnaire evaluating IHA adapted from Clarke Hypoglycemia Index (CHI) and validated among adult Filipino patients with Type 2 Diabetes Mellitus (T2DM).
Methodology:A questionnaire development study was conducted involving CHI linguistic translation, its modification through literature review and focus group discussions, panel synthesis, and content validity. A cross-sectional analytic study followed by administration of the questionnaire to 117 adult Filipinos with T2DM, advanced age, long-standing T2DM, insulin or sulfonylurea, polypharmacy, comorbidities and/or prior hypoglycemia. There were 9 participants in pilot testing, 69 in criterion validity against continuous glucose monitoring (CGM), and 108 in construct validity.
Results:IHA domains in the concept map included Elusive Euglycemia Model, Developmental Model, and Cognitive Model. The Filipino-CHI formulated had 8 questions with content validity scores ranging from 87.5-93.75%. Owing to brevity, its internal consistency Cronbach’s alpha was 0.45. Criterion validity against CGM yielded 21 patients with biochemical hypoglycemic events, of which 2 had clinical hypoglycemic events and 19 were positive monitor-identified IHA. A questionnaire IHA cutoff score of ≥4 had sensitivity of 89.47%, and area under the curve of 0.55.
Conclusion:An 8-item questionnaire evaluating IHA among adult Filipino T2DM patients was developed and validated. - Full text:JAFES 9.pdf
