{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:22:31Z","timestamp":1792142551571,"version":"4.4.0"},"reference-count":70,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T00:00:00Z","timestamp":1694563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Among adults with insulin\u2010 and\/or secretagogue\u2010treated diabetes in the United States, very little is known about the real\u2010world descriptive epidemiology of iatrogenic severe (level 3) hypoglycaemia. Addressing this gap, we collected primary, longitudinal data to quantify the absolute frequency of events as well as incidence rates and proportions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>iNPHORM is a US\u2010wide, 12\u2010month ambidirectional panel survey (2020\u20102021). Adults with type 1 diabetes mellitus (T1DM) or insulin\u2010 and\/or secretagogue\u2010treated type 2 diabetes mellitus (T2DM) were recruited from a probability\u2010based internet panel. Participants completing \u22651 follow\u2010up questionnaire(s) were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 978 respondents [T1DM 17%; mean age 51 (SD 14.3) years; male: 49.6%], 63% of level 3 events were treated outside the health care system (e.g. by family\/friend\/colleague), and &lt;5% required hospitalization. Following the 12\u2010month prospective period, one\u2010third of individuals reported \u22651 event(s) [T1DM 44.2% (95% CI 36.8%\u201051.8%); T2DM 30.8% (95% CI 28.7%\u201035.1%),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.0404, \u03b1\u2009=\u20090.0007]; and the incidence rate was 5.01 (95% CI 4.15\u20106.05) events per person\u2010year (EPPY) [T1DM 3.57 (95% CI 2.49\u20105.11) EPPY; T2DM 5.29 (95% CI 4.26\u20106.57) EPPY,\n                      <jats:italic>p<\/jats:italic>\n                      = .1352, \u03b1 = 0.0007]. Level 3 hypoglycaemia requiring non\u2010transport emergency medical services was more common in T2DM than T1DM (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .0001, \u03b1 = 0.0016). In total, &gt;90% of events were experienced by &lt;15% of participants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>iNPHORM is one of the first long\u2010term, prospective US\u2010based investigations on level 3 hypoglycaemia epidemiology. Our results underscore the importance of participant\u2010reported data to ascertain its burden. Events were alarmingly frequent, irrespective of diabetes type, and concentrated in a small subsample.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.15268","type":"journal-article","created":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T03:09:50Z","timestamp":1694574590000},"page":"3736-3747","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Severe (level 3) hypoglycaemia occurrence in a real\u2010world cohort of adults with type 1 or 2 diabetes mellitus (\n                    <scp>iNPHORM<\/scp>\n                    , United States)"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9474-7900","authenticated-orcid":false,"given":"Alexandria","family":"Ratzki\u2010Leewing","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry Western University  London Ontario 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