Endocrine Abstracts

Impaired awareness of hypoglycaemia (IAH) is associated with an increased risk of depression, anxiety, diabetes distress, and fear of hypoglycaemia in type 1 diabetes (T1D). We explored these associations in people with insulin-treated type 2 diabetes (T2D) and T1D in the Hypo-METRICS study. Hypo-METRICS was a 10-week cross-sectional observation of the hypoglycaemia experience, collecting data on glucose and activity. Participants (325 T2D, 277 T1D) completed questionnaires scoring depression (PHQ-9), anxiety (GAD-7), diabetes distress (PAID), and fear of hypoglycaemia (HFS-II [worry]) at baseline. IAH was defined as a Gold score ≥4. The relationships between IAH and the mental health scores were explored using generalised linear regression analyses. In the T2D group, there was a male predominance (63%). 27% had IAH (88/325), and 40% used continuous glucose monitors (CGM). In the adjusted linear regression, IAH was associated with higher HFS-II (worry) (5.3% [0.3%-10.6%]; P 0.048) but not PHQ-9 (P 0.582), GAD-7 (P 0.221), or PAID (P 0.23) scores. In the T1D group, there was a female predominance (54%). 21% had IAH (58/277), and 76% used CGM. In the adjusted linear regression in T1D, IAH was associated with higher PHQ-9 (8.3% [3.2%-13.3%; P 0.001), GAD-7 (9.33% [2.69%-16%; P 0.006), PAID (8.43% [2.62%-14.24%; P 0.005), and HFS-II (worry) (7.86% [1.57%-14.12%; P 0.015) scores. Our data demonstrated associations between IAH and a greater mental health burden in both T2D and T1D. Addressing these mental health challenges should be an important part of the holistic care of people with IAH and insulin-treated diabetes.