Effects of Continuous Glucose Monitoring on Impaired Awareness of Hypoglycemia in Older Adults With Type 1 Diabetes: A Post Hoc Analysis of the WISDM Study
Year: 2025
Type: article
Abstract: OBJECTIVE: Although continuous glucose monitoring (CGM) reduces hypoglycemia and may improve impaired awareness of hypoglycemia (IAH), its effectiveness in older adults at high risk remains unknown. RESEARCH DESIGN AND METHODS: This post hoc analysis of the WISDM study focuses on CGM use over 52 weeks. IAH was assessed using the Clarke original score (Clarke-full) and its subscales, Hypoglycemia Awareness Factor (HAF) and Severe Hypoglycemia Experienced Factors (SHEF), at baseline, 26 weeks, and 52 weeks. RESULTS: After 26 weeks (n = 184) and 52 weeks (n = 94) of CGM use, Clarke-SHEF decreased significantly (P = 0.02 and P < 0.0001, respectively), whereas Clarke-full and Clarke-HAF remained unchanged. After 52 weeks, Clarke-full but not Clarke-HAF improved in the IAH subgroup, highlighting the importance of selecting the appropriate scoring method for IAH. CONCLUSIONS: In older adults with type 1 diabetes, CGM improves hypoglycemia; however, its role in improving IAH is variable, depending on the scoring method. This study highlights the limitations of the Clarke score.
Source: Diabetes Care
DOI: 10.2337/dc25-0971
Authors: Anika Bilal, Fanchao Yi, Keri Whitaker, Zahra A. Khan, Richard E. Pratley, Anna Casu
Institutions: AdventHealth Orlando, AdventHealth, DePaul University
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4413965400