{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T19:41:03Z","timestamp":1783021263510,"version":"3.54.6"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Severe hypoglycemia is a major acute complication of type 1 diabetes (T1D) and is associated with increased morbidity, mortality, and impaired quality of life. Identifying individuals at the highest risk remains essential for optimising preventive strategies in real\u2010world practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The SEHYPAN (SEvere HYpoglycemia in ANdalusia) study was a multicenter case\u2013control analysis including adults with T1D treated with multiple daily insulin injections (MDI). Cases were individuals who required pre\u2010hospital emergency care for severe hypoglycemia between 2018 and 2022, each matched by sex, age, glucose\u2010monitoring method (SMBG\/isCGM), reference health\u2010care area with controls who had not experienced severe events. Logistic regression models were used to identify independent predictors, and nomograms were generated for individualised risk estimation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1464 participants were analysed (799 cases and 665 matched controls). Cases had longer diabetes duration, more comorbidities, and higher rates of smoking and alcohol use (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Two nomogram\u2010based models were developed: one for the overall cohort, including glucose monitoring modality, history of severe and nocturnal hypoglycemia, comorbid depression, alcohol use, and chronic conditions; and another specific to isCGM users, which also incorporated time in range and time below range. In the full cohort model, isCGM use was independently associated with lower odds of severe hypoglycemia. Both models showed good discrimination (AUC 0.75\u20130.83) and high sensitivity (\u2265\u00a00.75).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SEHYPAN study identifies key predictors of severe hypoglycemia in adults with T1D on MDI therapy. The innovative nomogram\u2010based models provide personalised risk estimates that may enhance preventive care in everyday clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.70151","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T14:17:58Z","timestamp":1772979478000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Validation of Nomogram\u2010Based Predictive Models for Severe Hypoglycemia in Adults With Type 1 Diabetes Treated With Multiple Daily Injections: The SEHYPAN Study"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0951-5428","authenticated-orcid":false,"given":"Pablo","family":"Rodr\u00edguez de Vera G\u00f3mez","sequence":"first","affiliation":[{"name":"Endocrinology and Nutrition Department University Hospital Virgen Macarena  Seville 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Le\u00f3n","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department University Hospital Virgen de Valme  Seville Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Dom\u00ednguez L\u00f3pez","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department Regional University Hospital of M\u00e1laga  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"S\u00e1nchez Malo","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department University Hospital of Jaen  Jaen Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almudena","family":"Lara Barea","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department University Hospital Puerta del Mar  C\u00e1diz 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