{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T13:38:29Z","timestamp":1777556309746,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We analyzed the effect of implementing a flash glucose monitoring (FGM) technology in a public health care system with universal coverage on the rate of severe hypoglycemia requiring urgent care in adults with type 1 diabetes mellitus (T1DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Using a comprehensive regional dataset, we extracted emergency care codes with hypoglycemia in individuals with T1DM who initiated the use of FGM in Andalucia, Spain, from January 1, 2020, to December 31, 2021. Severe hypoglycemia was defined as a confirmed blood glucose &lt;70 mg\/dL, which required the urgent dispatch of an emergency medical service (EMS) for onsite management. We compared hypoglycemic events reported in the 12 months before and after the initiation of FGM to determine the population incidence rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 13,616 participants with a mean age of 43.7\u2009\u00b1\u200913.5 years were included. The follow-up periods were 23.4 and 24.8 months before and after FGM. There were 969 and 737 cases of hypoglycemia before and after the initiation of FGM. The baseline incidence rate was 358.58 episodes per 10,000 person-years, which decreased to 260.9 at the end of the follow-up (rate-ratio 0.72 [0.66; 0.80]). The reduction in hypoglycemia was significant in individuals aged \u226560 years (rate-ratio 0.40 [0.28; 0.55]) and males (0.64 [0.56; 0.72]). In addition, there was a reduction in the overall median HbA1c of \u22120.35% (95% CI [\u22120.38; \u22120.33],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The implementation of FGM systems in a public health care system as a provision for adults with T1DM was associated with significant reductions in the rate of severe hypoglycemic events that required urgent EMS care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/dia.2024.0201","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T14:11:21Z","timestamp":1718633481000},"page":"951-959","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Population-Based Study on the Implementation of Flash Glucose Monitoring and Severe Hypoglycemia in Adults With Type 1 Diabetes"],"prefix":"10.1177","volume":"26","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":"Department of Endocrinology and Nutrition, University Hospital Virgen Macarena, Seville, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Mayoral S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Andalusian Comprehensive Healthcare Plan for Diabetes, Regional Ministry of Health, Andalusian Public Health System, Sevilla, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1ngel","family":"Vilches Arenas","sequence":"additional","affiliation":[{"name":"Preventive Medicine and Public Health Department, University of Seville, Seville, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reyes","family":"Rav\u00e9 Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, University Hospital Virgen Macarena, Seville, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"de la Cal Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Health Emergency Center 061 of Andalusia (CES-061), Cordoba, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillermo","family":"Umpierrez","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Asunci\u00f3n","family":"Mart\u00ednez-Brocca","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, University Hospital Virgen Macarena, Seville, Spain."},{"name":"Andalusian Comprehensive Healthcare Plan for Diabetes, Regional Ministry of Health, Andalusian Public Health System, Sevilla, 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