Résumé
Impaired awareness of hypoglycemia (IAH) is attributed to hypoglycemia exposure. Continuous glucose monitoring (CGM) detects more hypoglycemia particularly during sleep. We compared rates and duration of sensor detected hypoglycemia (SDH) and patient reported hypoglycemia (PRH) in people with type 1 diabetes (T1D) using CGM or flash monitoring.We recruited 92 participants with T1D using CGM/Flash reporting >1 hypoglycemic episode in the last month. Participants were defined as normal awareness of hypoglycemia (NAH) (Gold score <4; n=70) and IAH (Gold score >4; n=22) . All wore an additional blinded CGM and recorded episodes of PRH (symptomatic episodes that resolved on carbohydrate ingestion, or a measured glucose <72mg/dl) in real time on a smartphone app for weeks. Sleep status was obtained using an actigraphy monitor. Time in range (59.4 vs. 62.4%; p=0.18) and time < 70 mg/dl (4.6 vs. 6.0%; p=0.44) were not different between groups. Rates and duration of SDH < 70 mg/dl, < 55 mg/dl and < 40 mg/dl during sleep and awake were not different (table 1) . Rates of PRH were also not different (table 1) . While CGM has benefits, it cannot be used to define IAH. CGM allows people with IAH to self-detect hypoglycemia similar to those with NAH, providing a technology supported awareness.