Background: Severe hypoglycemia (SH) poses a significant challenge in the management of type 1 diabetes (T1D); however, the factors that offer protection other than diabetes technologies are under-studied. The primary objective of this study was to examine the association between hypoglycemia problem-solving (HPS) abilities and severe hypoglycemic events in adults with T1D using Poisson regression analysis.
Methods: In this cross-sectional study, 287 adults with T1D (mean age: 50.3 ± 14.5 years, male: 36.2%, diabetes duration: 17.5 ± 11.2 years, mean HbA1c: 7.7 ± 0.9%) were included and categorized into two groups: non-SH (n = 262) and SH (n = 25). Data on diabetic complications, the hypoglycemia problem-solving scale (HPSS), and treatment details were collected. Impaired awareness of hypoglycemia (IAH) was evaluated using Gold's method. Univariate and multivariable Poisson regression models were used for the analysis, and the findings were presented as incidence rate ratios (IRRs) at 95% confidence intervals (CIs).
Results: The incidence of SH was 16.7 (95% CI: 7.5-26.0) per 100 person-years. Univariate Poisson regression analysis associated IAH, diabetic peripheral neuropathy (DPN), problem-solving perception score of HPSS (HPSS1), real-time continuous glucose monitoring use, continuous subcutaneous insulin infusion usage with SH, whereas multivariate Poisson regression analysis significantly associated the HPSS 1 score (IRR: 0.51, 95% CI: 0.34, 0.76; P = 0.001) and DPN (IRR: 4.65, 95% CI: 1.96-11.04; P < 0.001) with SH.
Conclusion: We identified HPS abilities, in addition to DPN, were associated with SH in adults with T1D.
S. Sakane: None. N. Sakane: None.
