Factors Associated With Progression From Level 1 to Level 2 Sensor‐Detected Hypoglycaemia in People With Type 1 and Insulin‐Treated Type 2 Diabetes: A Post Hoc Analysis From the Hypo‐ METRICS Study
Authors' conclusion
Approximately one sixth of SDH events progressed to L2, with a higher proportion in T1D than T2D. The principal determinants were CV in T1D and mean glucose in T2D. Awareness status was not associated with progression risk during sleep.
Study context
- Population
- People with T1D and insulin-treated T2D with ≥ 1 hypoglycaemic event in preceding 3 months, wearing blinded CGM and FitBits for 10 weeks23,768 sensor-detected hypoglycaemic (SDH) events
- Participants
- 212 vs 213
- Comparison
- T1D vs insulin-treated T2D
- T1Dn = 212
- T2Dn = 213reference
- Primary endpoint
- L2 ratio: proportion of sensor-detected hypoglycaemic events progressing to level 2 (L2/(L1 + L2)), and associated variables
- Follow-up
- 10 weeks
Methodological detailsblinded CGM, beta regression, purposeful variable selection
- Blinded CGM
- Beta regression
- Purposeful variable selection
Primary result
As reported in the abstract
L2 ratio
P = 0.03
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Predictor of L2 ratio in T1D: CVCV | 1.07 (1.06–1.09) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
Predictor of L2 ratio in T2D: mean sensor glucose
| OR (95% CI) | P value | ||
|---|---|---|---|
| T2DMean sensor glucose | 1.13 (1.08–1.18) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
Other candidate predictors
- Mean L1-SDH duration, weekly L1-SDH frequency, personal CGM usage and impaired awareness were not principal predictors
Progression to L2 during sleep vs wakefulness
- Progression during sleep
- 21%
- Progression during wakefulness
- 11%
- Sleep vs wakefulness P
- P < 0.001
- L2 ratios during sleep did not differ by awareness status
Original publication
Factors Associated With Progression From Level 1 to Level 2 Sensor‐Detected Hypoglycaemia in People With Type 1 and Insulin‐Treated Type 2 Diabetes: A Post Hoc Analysis From the Hypo‐ METRICS Study. Diabetes Obes Metab. Published 4 August 2026. doi:10.
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