{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:38:50Z","timestamp":1792471130114,"version":"4.5.0"},"reference-count":49,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We investigated the proportion of sensor\u2010detected hypoglycaemic (SDH) events progressing to level 2, and associated variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      We used data from Hypo\u2010METRICS, which recruited people with type 1 (pwT1D) and insulin\u2010treated type 2 diabetes (pwT2D) with \u2265\u20091 hypoglycaemic event in preceding 3\u2009months, wearing blinded continuous glucose monitoring devices (CGM), additional to usual monitoring modality, and FitBits for 10\u2009weeks. We defined:\n                      <jats:list list-type=\"simple\">\n                        <jats:list-item>\n                          <jats:p>L1: SDH &lt;\u20093.9\u2009mmol\/L for \u2265\u200915\u2009min but \u2265\u20093.0\u2009mmol\/L;<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>L2: SDH &lt;\u20093.9\u2009mmol\/L with \u2265\u200915\u2009min of sensor glucose &lt;\u20093.0\u2009mmol\/L;<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            <jats:styled-content style=\"fixed-case\">L2<\/jats:styled-content>\n                            ratio\u2009=\u2009\n                            <jats:styled-content style=\"fixed-case\">L2<\/jats:styled-content>\n                            \/(\n                            <jats:styled-content style=\"fixed-case\">L1<\/jats:styled-content>\n                            \u2009+\u2009\n                            <jats:styled-content style=\"fixed-case\">L2<\/jats:styled-content>\n                            ), restricted to participants with both event types during the study period.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                    <jats:p>Associations of selected variables on L2 ratio was assessed using beta regression and purposeful variable selection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We analysed 23\u2009768 SDH events from 212 pwT1D and 213 pwT2D. PwT1D were predominantly female (53% vs. 42% in T2D,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023) and younger (median age 49 vs. 62\u2009years,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with a higher L2 ratio (16% vs. 14%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Coefficient of variation (CV), OR\u2009=\u20091.07, 95% CI\u2009=\u20091.06\u20131.09 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and mean sensor glucose, OR\u2009=\u20091.13, 95% CI\u2009=\u20091.08\u20131.18 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were the principal predictors in T1D and T2D respectively; mean L1\u2010SDH duration, weekly L1\u2010SDH frequency, personal CGM usage, impaired awareness were not. Progression was higher during sleep than wakefulness (21% vs. 11%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001); L2 ratios during sleep did not differ by awareness status.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Approximately one sixth of SDH events progressed to L2, with a higher proportion in T1D than T2D. The principal determinants were CV in T1D and mean glucose in T2D. Awareness status was not associated with progression risk during sleep.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71172","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T02:23:24Z","timestamp":1785896604000},"page":"9584-9594","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated With Progression From Level 1 to Level 2 Sensor\u2010Detected Hypoglycaemia in People With Type 1 and Insulin\u2010Treated Type 2 Diabetes: A Post Hoc Analysis From the Hypo\u2010\n                    <scp>METRICS<\/scp>\n                    Study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6120-8057","authenticated-orcid":false,"given":"Vaios","family":"Koutroukas","sequence":"first","affiliation":[{"name":"Diabetes Research Centre University of Leicester, College of Life Sciences  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterina","family":"Tziannou","sequence":"additional","affiliation":[{"name":"Cancer Research UK Clinical Trials Unit University of Birmingham  England UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonah J. 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