Evaluation of the hypoglycaemia symptom rating questionnaire (HypoSRQ) and its relationship with hypoglycaemic episodes measured using continuous glucose monitoring.

Diabetes Technology & Therapeutics 15 (Suppl 1): A23-A24 Abstract O-65.
Oral presentation at 6th International Conference on Advanced Treatments & Technologies (ATTD): 27th February-2nd March 2013, Paris, France.

Objective: To evaluate the psychometric properties of the Hypoglycaemia Symptom Rating Questionnaire (HypoSRQ © C.Bradley: www.healthpsychologyresearch.com) and the relationships between reported hypoglycaemic symptoms and measured hypoglycaemia using continuous glucose monitoring (CGM).

Patients and methods: Patients (53 men, 50 women), aged 18-86 years, with type 1 diabetes (n=65) for mean duration of 19.6 (SD=12.9) years and type 2 diabetes treated with insulin (n=38) for mean duration of 9.7 (SD=8.5) years, completed the HypoSRQ (recent-weeks version). Thirty patients used CGM (iPro2, Medtronic) for six days and completed the HypoSRQ (24-hour version) at the end of each day for seven days, the end of each week (7-day version), and the end of four weeks (recent-weeks version). Four patients used CGM for 28 days for within-person analyses.

Results: The HypoSRQ had a one-factor structure and excellent internal consistency (n=94, Cronbach’s α=0.90). There was high correspondence in recalled hypoglycaemic symptoms, bother ratings and hypoglycaemic episodes comparing the HypoSRQ daily versions with the weekly version, and the weekly versions with the recent-weeks version (r=0.84-0.97, p<0.001). HypoSRQ-reported hypoglycaemic episodes correlated significantly with CGM-measured hypoglycaemia in between-person (r=0.66, p<0.001) and within-person analyses (r=0.42-0.59, p<0.03). These relationships remained significant after adjustments for age, sex, treatment duration and type of diabetes.

Conclusions: The HypoSRQ has moderate to high sensitivity in detecting CGM-measured hypoglycaemia and its psychometric properties provide an attractive instrument for use in people with type 1 and insulin-treated type 2 diabetes. Further cross-validation and use of the HypoSRQ in different centres and in non-insulin treated patients is recommended.