I'm working on a methodical review on assessment of hypoglycemia (un)awareness in diabetic patients. Many publications refer on the so called "Gold score" [Gold et al. Diabetes Care 1994; 17(7):697-703]. In her original publication Ann Gold describes the criteria resp. definition of alteration in awareness of hypoglycemia, but I cannot find anywhere the original questions resp. the used questionnaire. Can anybody send me the originally used version of the "Gold" questionnaire?
On the other hand, maybe someone can explain the "Gold Score" to me?
As I understood, Gold et al. applied three criteria for assessing hypoglycemia awareness: (i) hypoglycemia symptoms, (ii) alteration in warning symptoms, and (iii) awareness of the onset of hypoglycemia. Criterion one was assessed with the symptom checklist from Hepburn. Criterion three was assessed by using a visual analog scale. But I don't know, whether I understood correctly the assessment of the second criterion. How did the authors operationalise the alteration in warning symptoms? Was it a single item or was it part of a questionnaire?
In many publications reffering the "Gold score" only the visual analog scale was used. Is there any explanation? Or ist the "Gold score" only this one-item visual analog scale?
As I remember, it is described in Høi-Hansen T, Pedersen-Bjergaard U, Thorsteinsson B. J Diabetes Complications. 2010 Nov-Dec;24(6):392-7. doi: 10.1016/j.jdiacomp.2009.07.006. Epub 2009 Sep 30. PMID: 19796968
It's a simple scale score from 1 (never aware) to 7(always aware) of symptoms associated with hypoglycaemia
It is thus a simple subjective assessment but which correlates well with the more complex Clarke score ( which is an amalgam of 7 questions)
It thus has the advantage of being very easy to apply in clinical practice, but the disadvantage of being relatively easy to be biased depending on the circumstances of the assessment (ie may not be an appropriate validated way to assess driving safety etc!!)
In the abovementioned article by Høi-Hansen et al the Gold and the Clarke score (and the pedersen-Bjergaard scale) is compared in respect to prediciting severe hypos.
Dear Peter, many thanks for your comments. Would you be able to sent me copy of the mentioned paper? We have no access to this journal at our clinic or at the universities of Wuerzburg or Bamberg. Kind regards, Michael
Hi all,
I am following with this topic and I would like to know if anybody can provide me with a review copy of the orginal Gold Instrument. Have you got any further information related to the conditions of use of this Questionnaire (fees, License). Any information would be very much appreciated!!! Thanks,
Piero
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