240-OR: Longitudinal Assessment of Glycemia and Severe Hypoglycemia among Adults with Type 1 Diabetes—An Online Survey

Abstract

Introduction & Objective: Longitudinal trends of glycemia and severe hypoglycemic events (SHE) among individuals with T1D are not well described, particularly in those using diabetes technologies (i.e., continuous glucose monitors [CGM], automated insulin delivery [AID]). Methods: An online survey recruited adults with T1D through the T1D Exchange Registry or online communities from February-April 2021. Overall, 2,044 individuals completed the survey and eligible participants were invited to complete follow-up survey from April-May 2023. Participants self-reported CGM use, insulin delivery method, HbA1c, impaired awareness of hypoglycemia (IAH), and SHE. Results: Of 1,999 eligible individuals, 1,056 completed the follow-up survey and were eligible for analysis (53% response rate; mean age: 46 y; mean T1D duration: 29 y; 71% female; 97% White). Most reported using CGMs at baseline (91.8%) and follow-up (94.4%), and use of AID increased (baseline: 53.5%; follow-up: 69.0%; Table). At baseline, 61.7% reported HbA1c <7% vs. 67.4% at follow-up. Rates of IAH and SHE in the prior year were similar at both time points. Conclusion: Despite nearly universal CGM usage and increased adoption of AID, one-third of respondents did not achieve HbA1c targets and the proportion of respondents with IAH and SHE did not decline. These results highlight the need for innovative approaches to improve T1D care. Disclosure J.L. Sherr: Consultant; Medtronic. Advisory Panel; Medtronic, Insulet Corporation. Speaker's Bureau; Insulet Corporation. Advisory Panel; Vertex Pharmaceuticals Incorporated, MannKind Corporation, StartUp Health T1D Moonshot, Bigfoot Biomedical, Inc., Cecelia Health. Speaker's Bureau; Zealand Pharma A/S. K. Hagan: Employee; Vertex Pharmaceuticals Incorporated. R. Bhak: Employee; Vertex Pharmaceuticals Incorporated, Novartis Pharmaceuticals Corporation. M. Peter: None. H. Nguyen: None. C. Wang: Employee; Vertex Pharmaceuticals Incorporated. T. Pakalapati: None. J. Sherwood: Employee; Vertex Pharmaceuticals Incorporated. T. Gupta: Employee; Vertex Pharmaceuticals Incorporated. J.L. Gaglia: Consultant; Vertex Pharmaceuticals Incorporated. Stock/Shareholder; Vertex Pharmaceuticals Incorporated. Consultant; Avotres Inc., Imcyse, Diamyd Medical. E.M. Cornelius: None. K.S.M. Chapman: None. W. Wolf: None. J. Pettus: Consultant; Sanofi, Novo Nordisk, Diasome, Carmot Therapeutics, Inc., Kriya Therapeutics, Lilly Diabetes, Provention Bio, Inc. Funding Vertex Pharmaceuticals Incorporated