🚨LATEST STUDY:

Despite Technological Advancements, Many Not Meeting BG Targets, & Hypoglycemia Significant Problem for People with Type 1 diabetes - Therapeutic Options Needed

🏃‍♀️TL;DR:

While CGM usage was associated with a higher proportion of participants achieving glycemic targets, a notable proportion still failed to meet these targets*.

Despite advancements in technology, a significant proportion of participants using the most advanced systems (AID) were unable to glycemic targets*. Hypoglycemia remains a significant problem for people with Type 1 diabetes, highlighting the need for further therapeutic options and strategies.

*The glycemic targets set by diabetes associations are 71% higher than the middle of the normal blood glucose range.

👨‍🏫Question:

Which therapeutic option has the greatest positive effect and impact on Type 1 diabetes management and outcomes❓

🙋‍♀️T1D Nutrition Solution:

A Therapeutic Carbohydrate Reduction/Low-carb nutrition strategy tailored for Type 1 diabetes.

1️⃣ Study Objective:

The study aims to characterize the prevalence of Severe Hypoglycemia Events (SHEs) and Impaired Awareness of Hypoglycemia (IAH) in individuals with Type 1 diabetes using different diabetes management approaches, including CGM and insulin pumps, while assessing glycemic metrics such as HbA1c.

2️⃣ Introduction:

- Global Impact of Type 1 Diabetes:
Type 1 diabetes affects over 8.7 million people worldwide, and exogenous insulin therapy has been the standard treatment for over a century.

- Glycemic Targets and Challenges:
Despite efforts, many individuals with Type 1 diabetes struggle to achieve glycemic targets, with only about one in four meeting the recommended target of HbA1c <7%.

⚠️ (Please note that this recommended HbA1C target of <7% is set by the diabetes organisations and is approximately 71% higher than an average blood glucose level of 90mg/dl or 5.0mmol/l, which is in the middle of the normal blood glucose range).

- Severe Hypoglycemic Events (SHEs):
Excess insulin relative to physiological needs can lead to severe hypoglycemia (SHE), which requires assistance and is associated with various risks including loss of consciousness, injury, and increased mortality. Recurrent SHEs can significantly impact quality of life.

3️⃣ Method:

- Participant Characteristics: The study included 2,044 participants with Type 1 diabetes, predominantly female (72.1%) and White (95.4%), with a mean age of 43.0 years and a mean duration of diabetes of 26.3 years. Most participants (91.7%) used CGM, with 50.8% using automated insulin delivery (AID) systems.

- Study Design: The study was observational and retrospective with cross-sectional elements. An online survey was utilized to collect data on glycemic metrics, severe hypoglycemic events (SHEs), and impaired awareness of hypoglycemia (IAH) in adults with Type 1 diabetes.

4️⃣ RESULTS:

- Severe Hypoglycemic Events (SHEs): Approximately 20% of participants reported at least one SHE in the previous 12 months, with 12.0% reporting two or more SHEs. The proportion of participants with at least one SHE was higher among non-CGM users compared to CGM users (25.4% vs. 10.8%).

- Impaired Awareness of Hypoglycemia (IAH): The prevalence of IAH, based on the modified Gold score, was 30.7% among all participants. The prevalence of IAH was slightly higher among CGM users compared to non-CGM users (31.1% vs. 26.0%).

🏁 CONCLUSION:

- High Adoption of Technology: Over 90% of participants used continuous glucose monitoring (CGM), with approximately half of CGM users also using automated insulin delivery (AID) systems. This high adoption rate provided a unique opportunity to assess the effectiveness of these technologies in a real-world setting.

- Persistence of Hypoglycemia Despite Advanced Technologies: Despite the use of advanced technologies like AID systems, a significant proportion of participants reported SHEs in the previous year (16.6%), indicating that hypoglycemia remains a significant problem for people with Type 1 diabetes.

- Role of Continuous Glucose Monitoring (CGM): Recent guidelines recommend CGM as a first-line approach in the management of Type 1 diabetes. While CGM usage was associated with a higher proportion of participants achieving glycemic targets, a notable proportion still failed to meet these targets.

- Challenges in Achieving Glycemic Targets: Despite advancements in technology, a significant proportion of participants using the most advanced systems (AID) were unable to meet glycemic targets, highlighting the need for further therapeutic options and strategies.

- Implications for Clinical Practice: The study emphasizes the importance of ongoing educational initiatives for individuals with Type 1 diabetes. Additionally, the development of novel therapeutic options, including bihormonal AID systems and b-cell replacement, will be crucial to enable more individuals to meet treatment goals.

👉 T1D Nutrition Interpretation and Conclusion 👈

1. Despite all the latest technological advancements a significant portion of those with Type 1 diabetes are unable to meet glycemic targets

2. Excess insulin relative to physiological needs can lead to severe hypoglycemia (SHE)

🦸‍♂️ The Solution:

Type 1 diabetes presents a metabolic challenge that demands a metabolic solution. This study underscores that despite technological advancements, current technology falls short of meeting diabetes association glycemic targets, let alone achieving normal blood glucose levels, which are the ultimate goal of T1D management for optimal health.

As the study concludes, there is a clear "need for further therapeutic options and strategies." These therapeutic options and strategies revolve around metabolism—specifically, nutrition. Type 1 diabetes is fundamentally a nutritional issue, one that technology alone cannot address. A targeted nutritional strategy is essential to enhance the management and outcomes of individuals with Type 1 diabetes.

If excessive insulin relative to physiological needs results in severe hypoglycemia, then insulin dosage must be reduced. However, to maintain normal blood glucose levels, we must decrease the glycemic load of our diet. By doing so, we can minimize blood glucose fluctuations, reduce the required insulin dosage, and provide individuals with Type 1 diabetes with the best opportunity to achieve normal blood glucose levels, thereby enhancing predictability and stability while fostering a safer environment.

⭐️ The call for further therapeutic options, as emphasized by the authors, underscores the necessity of a tailored nutrition strategy for managing Type 1 diabetes safely and effectively. That tailored nutrition strategy is Therapeutic Carbohydrate Reduction/Low-carb.

🎯 If you are interested in improving your child's Type 1 diabetes management and successfully implementing a Therapeutic Carbohydrate Reduction/low-carb nutrition strategy, so you can safely achieve normal blood sugar levels, relieve stress, anxiety, and frustration, and nourish your child's growing body, visit:

🖱 https://www.t1dnutrition.com/
📨 i[email protected]
📬 m.me/107379384792655

Follow T1D Nutrition on:
Website: https://www.t1dnutrition.com/
Facebook: https://www.facebook.com/t1dnutrition/
YouTube: https://www.youtube.com/@t1dnutrition

REFERENCE

Jennifer L. Sherr, Lori M. Laffel, Jingwen Liu, Wendy Wolf, Jeoffrey Bispham, Katherine S. Chapman, Daniel Finan, Lina Titievsky, Tina Liu, Kaitlin Hagan, Jason Gaglia, Keval Chandarana, Richard Bergenstal, Jeremy Pettus; Severe Hypoglycemia and Impaired Awareness of Hypoglycemia Persist in People With Type 1 Diabetes Despite Use of Diabetes Technology: Results From a Cross-Sectional Survey. Diabetes Care 2024; dc231765. https://doi.org/10.2337/dc23-1765

#t1dnutrition
#type1diabetes
#lowcarb
#lowcarbhighprotein
#TherapeuticCarbohydrateReduction
#NormalBloodGlucose
#normalbloodsugar