Cross-cultural validation of the HypoA-Q to measure hypoglycemic awareness in diabetic patients Validación transcultural del HypoA-Q para medir conciencia de hipoglucemia en pacientes diabéticos

Abstract

Introduction: hypoglycemia unawareness increases the risk of severe hypoglycemia in patients with diabetes. HypoA-Q is a questionnaire which allows us to evaluate hypoglycemia awareness including night time. However, a Spanish version is not available. Our objective is to translate and culturally adapt the HypoA-Q in order to be able to measure hypoglycemia awareness in Colombian patients with diabetes. Methodology: It is a cross-cultural adaptation study of the HypoA-Q instrument. Authorization was obtained from the author for its translation and adaptation to the Colombian population. The European Organization for Research and Treatment of Cancer (EORTC) methodology was followed. The researchers obtained a reconciled Spanish version with simple vocabulary. Two direct translations were performed by native Spanish speakers, one reconciled version, two reverse translations by two native English speakers, and a pilot test in 15 patients diagnosed with diabetes. Results: The direct translations into Spanish were similar. Adjustments were made to obtain a reconciled version with simple words. Also, glucose units were changed from mmol/L to mg/dl. The reverse translations were similar to the original in English. 15 patients older than 18 years read the Spanish version of HypoA-Q and answered a questionnaire to verify if each of the items were understandable, confusing, annoying or if it had difficult words. It did not require adjusting any item, since the frequency of items with comprehension difficulties, confusion or offensive words was less than 15%. Conclusions: The Spanish version of the HypoA-Q is available. An evaluation study of its psychometric properties must be carried out before being used in research studies or in clinical practice.