Introduction and Objective: The health and psychosocial impacts of recurrent severe hypoglycemic events (SHEs) and impaired awareness of hypoglycemia (IAH) in adults with type 1 diabetes (T1D) who use continuous glucose monitors (CGM) and insulin pumps remain poorly understood. This study describes the health and psychosocial burden of adults with T1D using CGM and insulin pumps with recurrent SHEs and IAH.Methods: This ongoing 12-month prospective online survey enrolled adults with T1D using CGM and insulin pumps with recurrent SHEs (≥2 SHEs in the past year) and IAH (Clarke score ≥4). Participants were recruited through patient advocacy groups from Canada, Germany, France, Italy, UK, and US. Participants reported diabetes-related complications and completed the Hypoglycemia Fear Survey-II (HFS-II) and the 17-item Diabetes Distress Scale (DDS-17). Baseline results are presented and compared against US T1D and general population norms for contextualization.Results: Participants (N=137) had a mean age of 49.6 years (range: 20-75), 71.5% were female, 65.0% were from the US, and mean T1D duration was 34 years (range: 5-72). Participants reported a mean of 5.7 SHEs (SD: 8.0) in the past year. The most frequently reported diabetes-related complications included mental health problems (79.6%), vision problems (58.4%), heart and circulation problems (50.4%), and nerve complications (46.7%). Participants reported high psychosocial burden: fear of hypoglycemia score (mean HFS-II total score 58.0, SD: 24.9) was 32% higher compared to the US T1D population norm (44.1). Diabetes distress was substantial (mean DDS-17 total score: 2.67, SD: 1.10), with 64.2% indicating moderate-to-high diabetes distress (DDS-17 score≥2), which warrants clinical support.Conclusion: Despite using CGM and insulin pumps, adults living with T1D and recurrent SHEs and IAH reported substantial health and psychosocial burden, highlighting continuing unmet needs.
A. Boateng-Kuffour: Employee; Current; Vertex Pharmaceuticals Incorporated. Q. Zhang: Employee; Current; Veloxis Pharmaceuticals, Inc. A. Albanese-O’Neill: Consultant; Current; Sanofi. Advisory Panel; Current; Roche Pharmaceuticals, Vertex Pharmaceuticals Incorporated. Research Support; Current; Abbott Diabetes. A. Bubeck: None. L. Green: Other – Sponsorship to my organization; Current; Abbott Diabetes, Vertex Pharmaceuticals Incorporated, Sanofi. B. Hauck: None. S. Heller: Consultant; Current; Novo Nordisk. Other – DSMC chair and member; Current; Eli Lilly and Company. Advisory Panel; Current; Zucara Therapeutics, Vertex Pharmaceuticals Incorporated. W. Polonsky: Consultant; Current; Vertex Pharmaceuticals Incorporated, Dexcom, Inc., Abbott Diabetes. Research Support; Current; Abbott Diabetes, Dexcom, Inc. Consultant; Current; Lilly Diabetes, MannKind Corporation. Research Support; Current; Lilly Diabetes. Consultant; Current; Sanofi, Insulet Corporation. P. Senior: Consultant; Ended; Abbott. Consultant; Current; Dexcom, Inc. Consultant; Ended; GlaxoSmithKline plc. Research Support; Current; Eli Lilly and Company. Consultant; Current; Novo Nordisk, Sana Biotechnology Inc., Sanofi, Vertex Pharmaceuticals Incorporated. Consultant; Ended; Ypsomed AG. J. Speight: Advisory Panel; Current; Vertex Pharmaceuticals Incorporated. Other – AU$10k Sponsorship for PSAD 2026 conference, Geelong, Australia; Current; Sanofi. S. Tutton: Advisory Panel; Ended; Vertex Pharmaceuticals Incorporated. Other – Patient Advisory Group Participation in the T1D Multi-National PRO study; Current; Vertex Pharmaceuticals Incorporated. R. Ziegler: Advisory Panel; Current; Abbott Diabetes, Vertex Pharmaceuticals Incorporated. Speaker’s Bureau; Current; Novo Nordisk. Advisory Panel; Current; Sanofi. Speaker’s Bureau; Current; Sanofi-Aventis Deutschland GmbH. Advisory Panel; Current; Roche Diabetes Care. N. Ainsworth: Consultant; Current; Vertex Pharmaceuticals Incorporated. C. Abbott: Employee; Current; Vertex Pharmaceuticals. A. Martin: Consultant; Current; Vertex Pharmaceuticals Incorporated. N. Li: Employee; Current; Vertex Pharmaceuticals Incorporated. Stock/Shareholder; Current; Vertex Pharmaceuticals Incorporated. B.L. Barber: None.
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