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Hypoglycaemia was not associated with depression, anxiety, diabetes distress, or fear of hypoglycaemia scores in people with type 1 or insulin-treated type 2 diabetes in the Hypo-METRICS study

Title: Hypoglycaemia was not associated with depression, anxiety, diabetes distress, or fear of hypoglycaemia scores in people with type 1 or insulin-treated type 2 diabetes in the Hypo-METRICS study
Authors: Evans, Mark; McCarthy, Aisling; Søholm, Uffe; Zoremba, Natalie; Pouwer, François; Vaag, Allan; Heller, Simon; Mader, Julia; Pedersen-Bjergaard, Ulrik; de Galan, Bastiaan; Renard, Eric; McCrimmon, Rory; Amiel, Stephanie; Choudhary, Pratik; Divilly, Patrick
Publisher Information: Wiley; Department of Medicine
Publication Year: 2026
Collection: Apollo - University of Cambridge Repository
Description: Background Hypoglycaemia is a common complication of insulin therapy. The relationship between hypoglycaemia and mood is not well understood, with conflicting evidence reported in the literature (1,2). Potential explanations for these conflicting data include the variation in hypoglycaemia definitions and thresholds. The strongest associations between hypoglycaemia and mental health appear to relate to severe hypoglycaemia (SH) (3), with impaired awareness of hypoglycaemia (IAH) being a major risk factor (4). Using the dataset with which we previously demonstrated an association between IAH and a mental health burden (5), this study provides an opportunity to explore whether this link operates through increased exposure to hypoglycaemia, using different common definitions of hypoglycaemia. Methods Hypo-METRICS was a prospective, multi-country observational study of the hypoglycaemia experience. Adults with type 1 diabetes (T1D) or insulin-treated type 2 diabetes (T2D) were eligible for inclusion. Participants wore blinded study continuous glucose monitors (CGMs), continued with their usual method of glucose monitoring (CGM or capillary blood glucose [CBG]), and completed ecological momentary assessment (EMA) through a bespoke app for 10 weeks in real-time (6). Participants completed patient-reported outcome measures (PROMs) at the beginning and end of the study to assess for depression (PHQ-9), anxiety (GAD-7), diabetes distress (PAID) and fear of hypoglycaemia (HFS-II [worry]) (Electronic Supplementary Material [ESM] Table 1). Hypoglycaemia was defined as time below range (TBR)
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: https://www.repository.cam.ac.uk/handle/1810/405056; https://doi.org/10.17863/CAM.131414
DOI: 10.17863/CAM.131414
Availability: https://www.repository.cam.ac.uk/handle/1810/405056; https://doi.org/10.17863/CAM.131414
Rights: Attribution 4.0 International ; https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.65F62893
Database: BASE