Hypoglycemia perception: Cross-cultural differences in Punjabi and Hindi speaking postmenopausal women

INTRODUCTION: The cross cultural differences in perception of menopausal symptoms are well known and these differences in perception of hypoglycemic symptoms in Russian-speaking and Caucasian postmenopausal women have been reported. AIMS AND OBJECTIVES: This study assessed cross – linguistic and cross – cultural differences in symptomatology of self reported hypoglycemia, between Punjabi and Hindi speaking diabetic post menopausal women. MATERIAL AND METHODS: Thirty Punjabi speaking and 20 Hindi speaking diabetic postmenopausal women aged over 50 years, were recruited for this study. Each subject was asked, what happens to you when you have low sugar? in the language of her choice, and spontaneous answers were recorded verbatim. STATISTICAL ANALYSIS: The data so obtained was analyzed by paper and pen method to obtain an understanding of the frequency of self reporting of various symptoms and then analyzed using Statistical Package for Social Science ver.19.0. RESULTS: Symptoms of hollowness, cold sweats and headache correlated significantly (P < 0.0001, P = 0.0001 and P = 0.03 respectively). One difference was noted in women from rural vs. urban background: Inability to concentrate was more frequent in urban women (4/23) vs rural women (0/27) (P < 0.0001). DISCUSSION: To our knowledge, this is the first exploratory work highlighting the differences in self reported hypoglycemia symptomatology, based on linguistic background. In India and other countries with multi ethnic, multi linguistic societies, linguistic competence in hypoglycemia history taking is important. LIMITATIONS: Incidence of hypoglycemia in the subjects enrolled was not assessed. Many of the subjects in the Punjabi speaking cohort were bilingual. Some symptoms of hypoglycemia may have been missed or over-reported by participants. CONCLUSION: Diabetes care professionals should be aware that persons with diabetes from varying linguistic backgrounds may report symptoms of hypoglycemia differently.