Beliefs Around Hypoglycemia and Their Impacts on Hypoglycemia Outcomes in Individuals with Type 1 Diabetes and High Risks for Hypoglycemia Despite Using Advanced Diabetes Technologies

Yu Kuei Lin, Caroline R. Richardson, Iulia Dobrin, Melissa J. Dejonckheere, Kara Mizokami-Stout, Michael D. Fetters, James E. Aikens, Simon J. Fisher, Wen Ye, Rodica Pop-Busui

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

OBJECTIVE This study aimed to 1) identify the frequency of severe and level 2 hypoglycemia presenting in individuals with type 1 diabetes using continuous glucose monitoring systems (CGMs), including those with concomitant closed-loop insulin pumps, in a clinical practice setting and 2) evaluate the impact of beliefs around hypoglycemia in the development of severe and level 2 hypoglycemia in this population. RESEARCH DESIGN AND METHODS A cross-sectional survey study in adults with type 1 diabetes using CGMs >6 months was conducted at a large tertiary academic center. Participant demo-graphics, 6-month severe hypoglycemia history, hypoglycemia beliefs (with the Attitude to Awareness of Hypoglycemia questionnaire), and 4-week CGM glucose data were collected. Statistical analysis was performed to assess the presentation of severe and level 2 hypoglycemia and identify associated risk factors. RESULTS A total of 289 participants were recruited (including 257 participants with CGM data within the last 3 months). Of these, 25.6% experienced at least one severe hypoglycemic episode in the last 6 months, and 13.6% presented with ‡1% of time in level 2 hypoglycemia on CGMs. Reporting beliefs about prioritizing hyper-glycemia avoidance was associated with severe hypoglycemia development (P < 0.001), while having beliefs of minimal concerns for hypoglycemia was associated with spending ‡1% of time in level 2 hypoglycemia (P = 0.038). CONCLUSIONS Despite the use of advanced diabetes technologies, severe and level 2 hypoglycemia continues to occur in individuals with type 1 diabetes and high hypoglycemia risks. Human factors, including beliefs around hypoglycemia, may continue to impact the effectiveness of glucose self-management.

Original languageEnglish
Pages (from-to)520-528
Number of pages9
JournalDiabetes Care
Volume45
Issue number3
DOIs
StatePublished - Mar 2022

Bibliographical note

Publisher Copyright:
© 2022 by the American Diabetes Association.

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

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