Evidence map›Paper›PMID 35935070›Full record

ArticleJournal of the Endocrine Society2022

Relationship Between Hypoglycemia Awareness Status on Clarke/Gold Methods and Counterregulatory Response to Hypoglycemia.

Nathan T Rubin, Elizabeth R Seaquist, Lynn Eberly, Anjali Kumar, Silvia Mangia, Gülin Öz, Amir Moheet

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in Journal of the Endocrine Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07547878 (A Pilot Randomized Clinical Trial to Assess Feasibility, Safety, and Efficacy of Rapid, Simultaneous Therapy Initiation in Chronic Kidney Disease and Type 2 Diabetes), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07547878 phase4not yet recruitingstarted 2026, after this paper: background citation

A Pilot Randomized Clinical Trial to Assess Feasibility, Safety, and Efficacy of Rapid, Simultaneous Therapy Initiation in Chronic Kidney Disease and Type 2 Diabetes: RAPID-CKD

Ran2026Enrolled64Registered outcomes18Posted comparisons0ConditionsChronic Kidney Disease, Type 2 DiabetesArmsAccupril, Aceon, Altace, Atacand, Avapro
Open the trial in the graph
3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Guideline
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Review
  11. Article
  12. Review
  13. Article
  14. Article
  15. Validating and Establishing a Diagnostic Threshold for the Hypoglycemia Awareness Questionnaire Impaired Awareness Subscale.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2023
    Article
  16. Article
  17. Review
  18. Review
  19. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Nathan T RubinDivision of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA.
Elizabeth R SeaquistDivision of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA.
Lynn EberlyDivision of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA.ORCID https://orcid.org/0000-0003-4763-330X
Anjali KumarDivision of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA.
Silvia MangiaCenter for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN 55455, USA.ORCID https://orcid.org/0000-0001-6341-4516
Gülin ÖzCenter for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN 55455, USA.
Amir MoheetDivision of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA.ORCID https://orcid.org/0000-0001-9909-6724
University of Minnesota · US

Funding

Vanderbilt Diabetes Research CenterP30DK020593 · NIDDK · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ALVIN C POWERS · 2012 to 2026
$29.3M
TRD4 - Ultrahigh Field Engineering and SafetyP41EB027061 · NIBIB · UNIVERSITY OF MINNESOTA · PI GREGOR ADRIANY · 2019 to 2026
$11.7M
NMR Imaging and SpectroscopyP41EB015894 · NIBIB · UNIVERSITY OF MINNESOTA · PI UGURBIL, KAMIL · 2012 to 2017
$8.4M
Measurement of glucose homestatsis in human brain by NMRR01NS035192 · NINDS · UNIVERSITY OF MINNESOTA TWIN CITIES · PI OZ, GULIN, SEAQUIST, ELIZABETH R. · 1997 to 2022
$8.3M
University of Minnesota Clinical and Translational Science Institute (UMN CTSI)KL2TR000113 · NCATS · UNIVERSITY OF MINNESOTA · PI BLAZAR, BRUCE R · 2012 to 2015
$5.4M
Institutional Center Cores for Advanced NeuroimagingP30NS076408 · NINDS · UNIVERSITY OF MINNESOTA · PI UGURBIL, KAMIL · 2012 to 2020
$4.2M
Identifying the Brain Substrates of Hypoglycemia Unawareness in Type 1 DiabetesR01DK099137 · NIDDK · UNIVERSITY OF MINNESOTA · PI MANGIA, SILVIA · 2014 to 2018
$2.5M
Identifying the Brain Substrates of Hypoglycemia Unawareness in Type 1 DiabetesR56DK099137 · NIDDK · UNIVERSITY OF MINNESOTA · PI MANGIA, SILVIA · 2013 to 2013
$248k
NCATS NIH HHS KL2 TR000113NIBIB NIH HHS P41 EB015894NIBIB NIH HHS P41 EB027061NIDDK NIH HHS P30 DK020593NIDDK NIH HHS R01 DK099137NIDDK NIH HHS R56 DK099137NINDS NIH HHS P30 NS076408NINDS NIH HHS R01 NS035192
6 · The paper itself

Abstract

Context: Impaired awareness of hypoglycemia (IAH) is characterized by the diminished ability to perceive symptoms of hypoglycemia. Gold and Clark questionnaires are commonly used to identify patients with IAH. The relationship between IAH status on questionnaires and a person's symptom and epinephrine responses to hypoglycemia are not well understood. Objective: We aimed to examine the relationship between hypoglycemia awareness status on Clarke and Gold questionnaires with both hormonal and symptomatic responses to experimental hypoglycemia. Methods: In this university medical center study, we examined data from 78 subjects with type 1 diabetes (T1D) who completed both questionnaires and underwent a hyperinsulinemic hypoglycemic clamp (target glucose 50 mg/dL). Results: Clarke and Gold scores were highly correlated with one another (r = 0.82) and each had a moderate negative relationship with epinephrine (Clarke: r = -0.51, Gold: r = -0.50) and total symptom response (Clarke: r = -0.59, Gold: r = -0.57). However, 32% of the subjects were classified inconsistently by Clark vs Gold. A clustering analysis was done to examine how disagreement between the 2 questionnaires on IAH classification relates to epinephrine and symptoms responses during hypoglycemia. Subjects who had partial loss of symptoms or of epinephrine response were more likely to be classified inconsistently. Conclusion: Our results show that IAH classification may be discordant between Clark and Gold questionnaires and that hypoglycemia awareness status on Clarke and Gold questionnaires poorly predicts hormonal and symptomatic responses to hypoglycemia in subjects with T1D and moderate blunting of symptoms or epinephrine.

Indexed as

Clarke questionnairesGold questionnaireshypoglycemiahypoglycemia unawarenessimpaired awareness of hypoglycemiatype 1 diabetes

Identifiers

PMID35935070
PMCPMC9351372
OpenAlexW4289277691

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.