PONE-D-21-10177Comprehensive Evaluation of patterns of Hypoglycemia Unawareness (HUA) and Glycemic Variability (GV) in patients with Fibro Calculous Pancreatic Diabetes (FCPD):  A cross-sectional study from South IndiaPLOS ONE

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PLOS ONE

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“This study was supported by a research grant awarded to SS from the Research Society for Study of Diabetes in India (RSSDI) ; Grant No: RSSDI/HQ/GRANTS/ 2018/460. The funding body had no role in study design, data collection and analysis,  preparation, review of the manuscript and decision to publish.”

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Additional Editor Comments:

Dear Dr Thomas,

In this manuscript, the authors examined the association of hypoglycemia unawareness and glycemic variability with glucagon secretion and cardia autonomic function in patients suffering from Fibrocalculous pancreatic diabetes (FCBD). The reviewers recommended that you make minor amendments to your manuscript. Please respond within the next 14 days to all comments raised by the reviewers.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

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Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: This is an intersting research article investigating predominantly the effect of hypoglycemia unawareness on glycemic variability on FCPD. The article is well written and provides useful additional information to the field. A significant number of patients have been recruited and the data is clear.

I have minor corrections:

1. Abstract: Please provide at least one introductory sentence in the background.

2. Please state/confirm whether the participants are taking any other class of medications e.g. statins.

3. Figure 2 is blurry and difficult to see. I'm not sure if this is an upload issue but it should be sorted.

4. Check grammar throughout, including missing full stops.

Reviewer #2: In this manuscript, the authors examined the association of hypoglycemia unawareness and glycemic variability with glucagon secretion and cardia autonomic function in patients suffering from Fibrocalculous pancreatic diabetes (FCBD). Reduced fasting and postprandial glucagon levels were observed to be significantly associated with the unaware group and were negatively correlated with hypoglycemia and cardia autonomic functions. This is an interesting article and will be useful for diabetes researchers and clinicians as it suggests a link between low levels of glucagon and hypoglycemia unawareness in FCBD. I recommend it for publication with minor revision:

Please discuss a little more on the significance of increased glucagon levels in the aware group.

I also spotted some typos that are listed below.

1. Fibrocalculous instead of fibrocalculous.

2. Line 66 Up to instead of upto

3. Line 68, most common instead of commonest.

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Reviewer #1: No

Reviewer #2: No

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Comprehensive Evaluation of patterns of Hypoglycemia Unawareness (HUA) and Glycemic Variability (GV) in patients with Fibro Calculous Pancreatic Diabetes (FCPD):  A cross-sectional study from South India

PONE-D-21-10177R1

Dear Dr. Thomas,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Mohamed A Elrayess

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: