{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T19:05:46Z","timestamp":1784574346913,"version":"3.55.0"},"reference-count":40,"publisher":"American Diabetes Association","issue":"8","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council-UK","doi-asserted-by":"crossref","award":["ID"],"award-info":[{"award-number":["ID"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council-UK","doi-asserted-by":"crossref","award":["MR\/R013349\/1"],"award-info":[{"award-number":["MR\/R013349\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council-UK","doi-asserted-by":"crossref","award":["MR\/V034162\/1"],"award-info":[{"award-number":["MR\/V034162\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council-UK","doi-asserted-by":"crossref","award":["Wellcome Trust (ID: 320878\/Z\/24\/Z)"],"award-info":[{"award-number":["Wellcome Trust (ID: 320878\/Z\/24\/Z)"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>We investigated the short-term association between ambient temperature and risk of hypoglycemia in adults with type 1 diabetes mellitus (T1DM). We hypothesized that higher ambient temperature would increase the odds of hypoglycemia developing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>We applied a case time series design to assess the longitudinal association between ambient temperature and hypoglycemia measured using routine continuous glucose monitoring data from individuals with T1DM. A quasi-binomial fixed-effect regression with distributed lag nonlinear models was used to estimate potentially nonlinear and lagged risks of nonoptimal temperature on hypoglycemic episodes, defined as \u226515 min of glucose concentration &amp;lt;3.9 mmol\/L. The model was adjusted for long-term trends, seasonality, day of the week, and public holidays. A secondary outcome was change in daily mean glucose concentration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>We analyzed 32,966,282 glucose readings from 679 adults with T1DM attending two National Health Service clinics in Sussex, England, between 2017 and 2024. Higher ambient temperatures were associated with an increased risk of hypoglycemia. The risk increased nonlinearly for temperatures above 13\u00b0C, with the odds ratio reaching 1.26 (95% CI 1.13\u20131.26) at 25\u00b0C. The strongest effect was observed on the same day of the exposure, and it diminished over subsequent days. In the secondary analysis, higher temperatures were associated with lower mean glucose levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Elevated ambient temperature significantly increases the short-term risk of hypoglycemia in adults with T1DM. These findings are specific to the U.K. population and climate, which may limit generalizability. Our results support anticipatory insulin adjustments during hot weather and consideration of ambient temperature in hybrid closed-loop insulin algorithms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc25-2383","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T16:32:32Z","timestamp":1774974752000},"page":"1323-1329","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["The Association Between Ambient Temperature and Hypoglycemia in People Living With Type 1 Diabetes: A Case Time Series Analysis Using Real-Time Continuous Glucose Monitoring"],"prefix":"10.2337","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7230-3946","authenticated-orcid":false,"given":"Harriet E.","family":"Daultrey","sequence":"first","affiliation":[{"name":"Department of Global Health and Infection, Brighton and Sussex Medical School 1 , Brighton, U.K."},{"name":"Environment & Health Modelling Lab, Department of Public Health Environments and Society, London School of Hygiene and Tropical Medicine 2 , London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3525-3633","authenticated-orcid":false,"given":"Nick S.","family":"Oliver","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Endocrinology and Metabolism, Imperial College London 3 , London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5820-8363","authenticated-orcid":false,"given":"Ali J.","family":"Chakera","sequence":"additional","affiliation":[{"name":"University Hospitals Sussex NHS Trust 4 , Brighton, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"de la Cruz Libardi","sequence":"additional","affiliation":[{"name":"Environment & Health Modelling Lab, Department of Public Health Environments and Society, London School of Hygiene and Tropical Medicine 2 , London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Collins C.","family":"Iwuji","sequence":"additional","affiliation":[{"name":"Department of Global Health and Infection, Brighton and Sussex Medical School 1 , Brighton, U.K."},{"name":"Africa Health Research Institute 5 , KwaZulu-Natal, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Gasparrini","sequence":"additional","affiliation":[{"name":"Environment & Health Modelling Lab, Department of Public Health Environments and Society, London School of Hygiene and Tropical Medicine 2 , London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"2026072014521146000_B1","unstructured":"Intergovernmental Panel on Climate Change\n          . 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