Limitations in Achieving Glycemic Targets From CGM Data and Persistence of Severe Hypoglycemia in Adults With Type 1 Diabetes Regardless of Insulin Delivery Method.

Laffel, Lori M; Sherr, Jennifer L; Liu, Jingwen; Wolf, Wendy A; Bispham, Jeoffrey; Chapman, Katherine S; Finan, Daniel; Titievsky, Lina et al. · Diabetes Care · 2025

cross_sectional · Level IV

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Abstract

We captured continuous glucose monitoring (CGM) metrics from a large online survey of adults with type 1 diabetes to determine how glycemic outcomes varied by insulin delivery form. Adults with type 1 diabetes from the T1D Exchange Registry/online communities completed the survey and contributed retrospective CGM data for up to 1 year. Self-reported glycemic outcomes and CGM measures were described overall and by insulin delivery method. The 926 participants completed the survey and provided CGM data. Mean ± SD age was 41.9 ± 15.7 years, and 50.8% reported using automated insulin delivery (AID). While AID users spent more time in range, 27.9% did not achieve time in range targets, 15.5% reported severe hypoglycemic events (SHEs), and 16.0% had CGM-detected level 2 hypoglycemic events. Despite use of diabetes technologies, many individuals are unable to achieve glycemic targets and experience severe hypoglycemia, highlighting the need for novel treatments.

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