{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:28:16Z","timestamp":1791473296946,"version":"4.3.4"},"reference-count":24,"publisher":"American Diabetes Association","issue":"4","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"name":"Vertex Pharmaceuticals Incorporated"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To assess longitudinal trends in glycemic metrics, prevalence of severe hypoglycemic events (SHEs), impaired awareness of hypoglycemia (IAH), and technology use (continuous glucose monitoring [CGM], automated insulin delivery [AID]) in a real-world U.S. cohort of adults with type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>This was a cross-sectional study of adults with type 1 diabetes conducted \u223c2 years after participants enrolled in the original retrospective observational study. Participants self-reported technology use, insulin delivery method, glycated hemoglobin (HbA1c), IAH, and SHEs. Change was assessed among these variables from the initial and follow-up study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Approximately 2 years after the original survey, 1,056 adults responded to the follow-up survey and were eligible for analysis (53% response rate; mean [SD] age: 46 [16] years; mean [SD] type 1 diabetes duration: 29 [16] years; 71% female; 97% White). Most reported using CGM in the original study (91.8%) and at follow-up (94.4%), while the use of AID increased 17.7%. In the original study, 61.7% reported HbA1c &amp;lt;7% vs. 67.4% at follow-up. Proportions of individuals with IAH and SHEs remained high at \u223c30% and \u223c20%, respectively, in both studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Although most participants used CGM and the use of AID increased, approximately one-third of respondents did not achieve HbA1c targets, \u223c20% continued to have SHEs in the last year, and \u223c30% had IAH. This highlights that while CGM and AID systems are a significant advancement, their use alone has not mitigated the risk of severe hypoglycemia, and glucose management still remains suboptimal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc25-2345","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T20:04:56Z","timestamp":1772136296000},"page":"650-657","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":3,"title":["Persistent Burden of Severe Hypoglycemia and Impaired Awareness of Hypoglycemia Among People With Type 1 Diabetes Despite Technology Use: A Follow-up Survey"],"prefix":"10.2337","volume":"49","author":[{"given":"Jennifer L.","family":"Sherr","sequence":"first","affiliation":[{"name":"Yale University School of Medicine 1 , New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca 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