The Correlation Between Fear and Perceived Frequency of Hypoglycemia and Continuous Glucose Monitoring Metrics in Adults With Type 1 Diabetes Using Diabetes Technology: A 1-Year Analysis

Abstract

OBJECTIVE To evaluate the association between fear and perceived frequency of hypoglycemia and continuous glucose monitoring (CGM) metrics in adults with type 1 diabetes using diabetes technology over 12 months. RESEARCH DESIGN AND METHODS This retrospective explorative analysis evaluated correlations between hypoglycemia fear, perceived hypoglycemia frequency, and CGM metrics in 1,370 adults with type 1 diabetes using real-time CGM (Comparing Continuous With Flash Glucose Monitoring in Adults With Type 1 Diabetes [ALERTT1] study,n= 254) or hybrid closed-loop (The Impact of Hybrid Closed-Loop Insulin Delivery in Type 1 Diabetes on Glycemic Control and PROMs [INRANGE] studies,n= 1,116) for 12 months. Hypoglycemia fear was assessed with the Hypoglycemia Fear Survey II worry (HFS-worry) and behavior (HFS-behavior) subscales and perceived hypoglycemia frequency with the hypoglycemia subscale of the Diabetes Treatment Satisfaction Questionnaire-status (DTSQs-hypo). Data are reported as mean +/- SD. RESULTS At baseline (before the start of technology), mean age was 41.0 +/- 13.7 years, 55.9% were women, diabetes duration was 21.6 +/- 12.7 years, HbA(1c)was 7.6 +/- 1.0% (59.0 +/- 10.8 mmol/mol), and time in 3.9-10.0 mmol/L was 61.1 +/- 15.5%. Over 12 months, time <3.9/<3.0 mmol/L decreased from 3.4 +/- 3.5%/0.8 +/- 1.4% to 2.3 +/- 2.2%/0.5 +/- 0.7%, while HFS-worry (21.0 +/- 12.9 to 16.8 +/- 12.1) and DTSQs-hypo (3.3 +/- 1.5 to 2.7 +/- 1.4) also decreased. HFS-worry, HFS-behavior, and DTSQs-hypo showed no clear correlations with time in hypoglycemia or other CGM metrics at baseline, at 12 months, or over 12-month change. CONCLUSIONS In adults using diabetes technology over 12 months, fear and perceived frequency of hypoglycemia showed no clear correlations with CGM metrics, suggesting both are influenced by more than glycemic profiles alone.