{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T16:00:40Z","timestamp":1780588840355,"version":"3.54.1"},"reference-count":20,"publisher":"American Diabetes Association","issue":"1","license":[{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR001878"],"award-info":[{"award-number":["UL1TR001878"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Although continuous glucose monitoring (CGM) reduces hypoglycemia and may improve impaired awareness of hypoglycemia (IAH), its effectiveness in older adults at high risk remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>This post hoc analysis of the WISDM study focuses on CGM use over 52 weeks. IAH was assessed using the Clarke original score (Clarke-full) and its subscales, Hypoglycemia Awareness Factor (HAF) and Severe Hypoglycemia Experienced Factors (SHEF), at baseline, 26 weeks, and 52 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>After 26 weeks (n = 184) and 52 weeks (n = 94) of CGM use, Clarke-SHEF decreased significantly (P = 0.02 and P &amp;lt; 0.0001, respectively), whereas Clarke-full and Clarke-HAF remained unchanged. After 52 weeks, Clarke-full but not Clarke-HAF improved in the IAH subgroup, highlighting the importance of selecting the appropriate scoring method for IAH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In older adults with type 1 diabetes, CGM improves hypoglycemia; however, its role in improving IAH is variable, depending on the scoring method. This study highlights the limitations of the Clarke score.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc25-0971","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T19:42:33Z","timestamp":1756928553000},"page":"86-91","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Continuous Glucose Monitoring on Impaired Awareness of Hypoglycemia in Older Adults With Type 1 Diabetes: A Post Hoc Analysis of the WISDM Study"],"prefix":"10.2337","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4401-1222","authenticated-orcid":false,"given":"Anika","family":"Bilal","sequence":"first","affiliation":[{"name":"AdventHealth Translational Research Institute 1 , Orlando, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanchao","family":"Yi","sequence":"additional","affiliation":[{"name":"AdventHealth Translational Research Institute 1 , Orlando, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keri","family":"Whitaker","sequence":"additional","affiliation":[{"name":"AdventHealth Translational Research Institute 1 , Orlando, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra A.","family":"Khan","sequence":"additional","affiliation":[{"name":"DePaul University 2 , Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard E.","family":"Pratley","sequence":"additional","affiliation":[{"name":"AdventHealth Translational Research Institute 1 , Orlando, FL"},{"name":"AdventHealth Diabetes Institute 3 , Orlando, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Casu","sequence":"additional","affiliation":[{"name":"AdventHealth Translational Research Institute 1 , Orlando, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"key":"2026060411120691200_B1","doi-asserted-by":"crossref","first-page":"e15480","DOI":"10.1111\/dme.15480","article-title":"Prevalence and risk factors for impaired awareness of hypoglycaemia: a registry-based study of 10,202 adults with type 1 diabetes in Norway","volume":"42","author":"Hernar","year":"2025","journal-title":"Diabet Med"},{"key":"2026060411120691200_B2","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1111\/j.1464-5491.2008.02413.x","article-title":"Prevalence of impaired awareness of hypoglycaemia in adults with type 1 diabetes","volume":"25","author":"Geddes","year":"2008","journal-title":"Diabet Med"},{"key":"2026060411120691200_B3","doi-asserted-by":"crossref","first-page":"316","DOI":"10.2337\/dc14-0920","article-title":"Hypoglycemia and risk of cardiovascular disease and all-cause mortality in insulin-treated people with type 1 and type 2 diabetes: a cohort study","volume":"38","author":"Khunti","year":"2015","journal-title":"Diabetes Care"},{"key":"2026060411120691200_B4","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1007\/s11657-018-0475-z","article-title":"Severe hypoglycemia is associated with high risk for falls in adults with type 1 diabetes","volume":"13","author":"Shah","year":"2018","journal-title":"Arch Osteoporos"},{"key":"2026060411120691200_B5","doi-asserted-by":"crossref","first-page":"2243","DOI":"10.1111\/dom.15102","article-title":"Impact of severe hypoglycaemia requiring hospitalization on mortality in people with type 1 diabetes: a national retrospective observational cohort study","volume":"25","author":"Moser","year":"2023","journal-title":"Diabetes Obes Metab"},{"key":"2026060411120691200_B6","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/S0140-6736(94)91336-6","article-title":"Restoration of hypoglycaemia awareness in patients with long-duration insulin-dependent diabetes","volume":"344","author":"Cranston","year":"1994","journal-title":"Lancet"},{"key":"2026060411120691200_B7","doi-asserted-by":"crossref","first-page":"517","DOI":"10.2337\/diacare.18.4.517","article-title":"Reduced awareness of hypoglycemia in adults with IDDM. 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