The Impact of Hypoglycaemia on Quality of Life in Adults With Type 1 Diabetes Using Contemporary Diabetes Technologies: A US National Survey

BACKGROUND: Use of contemporary diabetes technologies, including continuous glucose monitoring (CGM) and hybrid closed-loop insulin pumps (HCLs), has expanded rapidly among people with Type 1 diabetes. However, limited research has characterised the impact of hypoglycaemia on quality of life in this population. METHODS: We analysed cross-sectional survey data from US adults aged ≥ 18 years who were using CGM or HCL and who were recruited through the T1D Exchange. Survey responses included participant characteristics, diabetes technology use, and hypoglycaemia-specific quality of life measured by the 12-item Hypoglycaemia Impact Profile (HIP-12), which assesses hypoglycaemia-related impact across 12 major life domains. HIP-12 composite and domain-specific scores were summarised and compared between CGM-only (without HCL) and HCL users. RESULTS: The analytic sample included 796 participants (mean age 47 years; 53% female), of whom 23% used CGM only and 77% used HCL. Overall, 96% reported at least one life domain negatively affected by hypoglycaemia, and 31% reported negative impacts across 10 or more of the 12 assessed domains. The most frequently negatively affected domains were sleep, leisure activities, emotional well-being, spontaneity and physical activity/fitness. Compared with CGM-only users, HCL users reported greater hypoglycaemia-related negative impacts on leisure activities (p < 0.001), physical activity/fitness (p < 0.001), spontaneity (p = 0.011), sex life (p = 0.014) and work or studies (p = 0.021). CONCLUSIONS: Hypoglycaemia continues to adversely affect multiple related quality-of-life domains despite using contemporary diabetes technologies. Routine clinical assessment of and clinical support for hypoglycaemia's impact remain important. Further research is needed to clarify the mechanisms underlying these impacts and to guide targeted interventions.