2025/09/03 by Anika Bilal, Fanchao Yi, Keri Whitaker +3 · 1 voice
Health Professions · Medicine · #Diabetes Management and Research #Hyperglycemia and glycemic control in critically ill and hospitalized patients #Mobile Health and mHealth Applications
paper · doi:10.2337/dc25-0971
openalex publication_date 2025/09/03 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
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.