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 demographics, 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 hyperglycemia 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.

中文翻译：

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关于低血糖的信念及其对 1 型糖尿病患者低血糖结果的影响以及尽管使用先进的糖尿病技术仍存在低血糖高风险

目的 本研究旨在 1) 在临床实践环境中使用连续血糖监测系统 (CGM) 确定 1 型糖尿病患者出现严重和 2 级低血糖的频率，包括伴随闭环胰岛素泵的患者，以及 2)评估围绕低血糖的信念对该人群发生严重和 2 级低血糖的影响。研究设计和方法 在大型三级学术中心使用 CGMs >6 个月对成年 1 型糖尿病患者进行横断面调查研究。收集了参与者的人口统计资料、6 个月的严重低血糖病史、低血糖信念（使用低血糖意识问卷的态度）和 4 周的 CGM 葡萄糖数据。进行统计分析以评估严重和 2 级低血糖的表现并确定相关的风险因素。结果 共招募了 289 名参与者（包括最近 3 个月内有 CGM 数据的 257 名参与者）。其中，25.6% 的患者在过去 6 个月内经历过至少一次严重的低血糖事件，13.6% 的患者在 CGM 上出现≥1% 的 2 级低血糖。报告关于优先避免高血糖的信念与严重低血糖的发生有关 (P < 0.001)，而对低血糖的最小担忧与 2 级低血糖花费 ≥ 1% 的时间有关 (P = 0.038)。结论 尽管使用了先进的糖尿病技术，严重和 2 级低血糖继续发生在患有 1 型糖尿病和高低血糖风险的个体中。人为因素，包括对低血糖的看法，可能会继续影响血糖自我管理的有效性。