Cited by 52Diabetes Management and ResearchDiabetes Management and EducationPatient Safety and Medication Errors

Hypoglycaemia in type 1 diabetes: technological treatments, their limitations and the place of psychology

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Choudhary, Pratik, Amiel, Stephanie A.·2018·Diabetologia

Abstract

Advances in technology allowing improved insulin delivery and glucose monitoring can significantly reduce the burden of hypoglycaemia when used appropriately. However, limitations of the current technology, and the skills, commitment and motivation required to use them, mean that it does not work for all people. Education and informed professional support are key to success. In the context of problematic hypoglycaemia, data suggest that newer technology has lower efficacy and uptake in those with most need. Identifying the causes of hypoglycaemia and understanding some of the underlying behavioural drivers may prove useful and psycho-educational strategies may be effective in selected individuals. Ultimately, as in many spheres of medicine, successful management of problematic hypoglycaemia depends upon matching the right treatment to the right individual.

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  • Recurrent level 2 hypoglycemia and/or level 3 hypoglycemia is an urgent medical issue and requires intervention with medical treatment plan adjustment, behavioral intervention, and, in some cases, use of technology to assist with hypoglycemia prevention and identification.

    “Recurrent level 2 hypoglycemia and/or level 3 hypoglycemia is an urgent medical issue and requires intervention with medical treatment plan adjustment, behavioral intervention, and, in some cases, use of technology to assist with hypoglycemia prevention and identification (76,(79)(80)(81)(82).”
  • Some individuals with type 1 diabetes or type 2 diabetes and hypoglycemia who have a fear of hyperglycemia are resistant to relaxation of glycemic targets.

    “Conversely, some individuals with type 1 diabetes or type 2 diabetes and hypoglycemia who have a fear of hyperglycemia are resistant to relaxation of glycemic targets (74)(75)(76)(77)(78)(79)(80)(81)(82)(83).”
  • Among children and adolescents with T1D, alarm fatigue was at least one of the reasons for discontinuing CGM.

    “Among 85 children and adolescents between 5 and 18 years old with T1D, alarm fatigue was found to be the main reason for discontinuing CGM [ 43 ], or at least one of the reasons [ 32 , 67 ].”

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Authors
Choudhary, P., & Amiel, S. A.
Affiliations
King's College London (GB)
Corresponding author
Amiel, Stephanie A.
Venue
Diabetologia
Published
2018-02-08
Volume
61
Issue
4
Pages
761-769
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
OpenAlex
W2790913112
Cited by
52
References
88
Citations by year
2026: 2 · 2025: 6 · 2024: 6 · 2023: 7 · 2022: 12 · 2021: 4 · 2020: 5 · 2019: 6 · 2018: 4
FWCI
0.73
Type
journal article
Language
en
Open access
Locations
  • Diabetologia (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (publishedVersion, other-oa)
Funders
King's College London
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
Keywords
hypoglycemia, type 1 diabetes, continuous glucose monitoring, insulin pump, patient motivation, medication adherence, personalized treatment, diabetes education
MeSH terms
Awareness, Blood Glucose, Diabetes Mellitus, Type 1, Mental Fatigue, Fear, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Motivation, Patient Compliance, Professional-Patient Relations, Self Care, Blood Glucose Self-Monitoring, Treatment Outcome, Clinical Alarms

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