Exploring the gap between sensor-detected (SDH) and person-reported hypoglycaemia (PRH): The voice of people living with diabetes

Background and Aims: In people with insulin-treated diabetes experiencing hypoglycaemia, the multicentre Hypo-METRICS study found that 60% of sensor-detected hypoglycaemic episodes (SDH) were asymptomatic, and over 40% of person-reported hypoglycaemia (PRH) occurred at glucose levels ≥70 mg/dL (3.9 mmol/L). This subanalysis explored participants' experiences of these episodes to identify possible clinical implications. Methods: Fifty-eight Austrian participants received a 15-item questionnaire on their experience of asymptomatic hypoglycaemia and symptoms at glucose levels ≥70 mg/dL (3.9 mmol/L). Results: The response rate was 86% (n = 50). Among all participants, 56% (n = 28) reported experiencing hypoglycaemic symptoms at glucose levels ≥70 mg/dL (3.9 mmol/L) “sometimes” or “often.” They attributed this to a combination of a threshold shift due to chronic hyperglycaemia, rapid glucose decline and fear of hypoglycaemia. 68% of all SDH < 70 mg/dL and 59% of those below the clinically critical level of 54 mg/dL were asymptomatic. Conclusion: These results demonstrate that SDH and PRH each capture different, yet equally important, dimensions of the hypoglycaemia experience. Relying on only one source of information inevitably provides an incomplete picture. By integrating the patient's voice, diabetes professionals can provide appropriate support and tailor continuous glucose monitoring (CGM) alarm settings and treatment plans to truly meet individual needs.