People with type 1 diabetes and impaired awareness of hypoglycaemia have a delayed reaction to performing a glucose scan during hypoglycaemia: a prospective observational study

AIMS: Considering that people with type 1 diabetes and impaired awareness of hypoglycaemia (IAH) have a delayed perception of hypoglycaemia, the question arises whether they perform scans later in case of hypoglycaemia than people without IAH. We assessed whether time to performing a scan after reaching hypoglycaemia while using a flash glucose monitoring (flash GM) system is different in people with IAH compared with people without IAH. METHODS: Ninety‐two people with type 1 diabetes [mean (± sd) age 42 ± 14 years, HbA(1c) 57 ± 9 mmol/mol] using a flash GM system for 3 months were included. Flash GM data were assessed for time until scan after reaching hypoglycaemia level 1 (< 3.9 mmol/l) and level 2 (< 3.0 mmol/l) and compared for type 1 diabetes with vs. without IAH via unpaired t‐test/Mann–Whitney U test (P < 0.05). RESULTS: Significant differences were found only for the delay between reaching hypoglycaemia and scan between people with and without IAH for Gold score [hypoglycaemia level 1: IAH 78 (51–105) min vs. without IAH 63 (42–89) min, P = 0.03; night‐time hypoglycaemia level 2: IAH 140 (107–227) min vs. without IAH 96 (41–155) min, P = 0.004] and Pedersen‐Bjergaard score [hypoglycaemia level 1: IAH 76 (52–97) min vs. without IAH 54 (38–71) min, P = 0.011; night‐time hypoglycaemia level 1: IAH 132 (79–209) min vs. without IAH 89 (59–143) min, P = 0.011; night‐time hypoglycaemia level 2: IAH 134 (66–212) min vs. without IAH 80 (37–131) min, P = 0.002). Data are shown as median (i.q.r.). CONCLUSIONS: Time until scan after reaching hypoglycaemia might be an objective assessment tool for IAH, but needs to be investigated comprehensively in future studies.