ArticleDiabetic medicine : a journal of the British Diabetic Association2025
Predictors of impaired awareness of hypoglycaemia and severe hypoglycaemia in adults with type 1 diabetes.
Article in Diabetic medicine : a journal of the British Diabetic Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Associations between impaired awareness of hypoglycaemia and mental health in insulin-treated type 2 and type 1 diabetes in the Hypo-METRICS study.Diabetic medicine : a journal of the British Diabetic Association · 2026Observational
- Clinical and socioeconomic determinants of glycaemic control derived from continuous glucose monitoring in adults with type 1 diabetes.Frontiers in endocrinology · 2026Article
- Time below range alone is insufficient to identify severe hypoglycaemia risk in type 1 diabetes-the critical role of hypoglycaemia awareness: results from the SFDT1 study.Diabetologia · 2025Observational
- Predictors of impaired awareness of hypoglycaemia and severe hypoglycaemia in adults with type 1 diabetes.Diabetic medicine : a journal of the British Diabetic Association · 2025Article
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Authors and funding
8 authors.
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Abstract
aimsThis study aimed to assess the prevalence of impaired awareness of hypoglycaemia (IAH) and severe hypoglycaemia (SH) in adults with type 1 diabetes and identify risk factors for both conditions in a contemporary cohort.
methodsA cross-sectional survey was conducted on 782 adults with type 1 diabetes. Participants completed a questionnaire including validated hypoglycaemia awareness and mental health tools. Continuous glucose monitoring (CGM) data were collected in 402 participants. SH was identified based on self-reported episodes.
results89% were CGM users and 27% were using continuous subcutaneous insulin infusion (CSII). 5.3% of participants reported a recent episode of SH and 21% had IAH based on the Gold score. Elevated Gold Score was independently associated with socioeconomic deprivation (OR 1.9, p = 0.002), female sex (OR 1.8, p = 0.002) and positive depression screen (OR 2.1, p = 0.007). Hypoglycaemia detection threshold <3.0 mM was independently associated with older age (OR 1.03 per year, p < 0.001) and positive depression screen (OR 2.7, p < 0.001). Greater glucose variability (OR 1.14 per % CV glucose, p < 0.001), positive anxiety screen (OR 3.0, p = 0.031) and detection threshold <3.0 mM (OR 6.7, p < 0.001) were all independently associated with SH risk.
conclusionsThe prevalence of SH is lower in the modern era of type 1 diabetes management and may reflect greater use of CGM and CSII. Mental health symptoms and socioeconomic deprivation are key associations with IAH and SH. Risk models incorporating clinical, psychological and CGM data may more effectively predict SH.
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