Characterizing Severe and Level 2 Hypoglycemia and Associated Risk Factors in Adults with Type 1 Diabetes Using Hybrid Closed-Loop Insulin Pumps
Authors' conclusion
Among adults with type 1 diabetes using HCL insulin pumps, IAH and higher glucose CVs are risk factors of experiencing SH and Lv2Hypo. Hyperglycemia and lower education level are also associated with a higher risk for experiencing SH.
Study context
- Population
- Adult hybrid closed-loop (HCL) insulin pump users with T1D from a national U.S. T1D patient registry; female 54%, mean age 43
- Participants
- 601 users
- Exposure
- Characteristics associated with severe hypoglycemia (SH) and ≥1% time in level 2 hypoglycemia
- Outcome
- SH (6-month history) and spending ≥1% of time in level 2 hypoglycemia (Lv2Hypo); association with IAH and other patient characteristics
Methodological detailssurvey, national U.S. T1D patient registry, Analyses: logistic regression, t-tests, Chi-square tests, Assessed 6-month SH history, HbA1c, impaired awareness of hypoglycemia (IAH) (Hypoglycemia Awareness Questionnaire), 30-day continuous glucose monitoring (CGM) data
- Survey
- National U.S. T1D patient registry
- Analyses: logistic regression, t-tests, Chi-square tests
- Assessed 6-month SH history, HbA1c, IAH (Hypoglycemia Awareness Questionnaire), 30-day CGM data
Main finding
As reported in the abstract
IAH and higher glucose CVs associated with both SH and ≥1% time in Lv2Hypo
Ps < 0.05
Individuals with SH spent more time with glucose >180 mg/dL and >250 mg/dL and had lower education level
Ps < 0.05
Observational data: associations, not effects.
Further findings
Both SH and ≥1% time in Lv2Hypo
- Trends toward most severe IAH and highest glucose CVs
Original publication
Characterizing Severe and Level 2 Hypoglycemia and Associated Risk Factors in Adults with Type 1 Diabetes Using Hybrid Closed-Loop Insulin Pumps. Diabetes Technol Ther. Published 2 July 2025. doi:10.
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