ArticleDiabetic medicine : a journal of the British Diabetic Association2022
Impaired awareness of hypoglycaemia in women with type 1 diabetes in pregnancy: Hypoglycaemia fear, glycaemic and pregnancy outcomes.
Article in Diabetic medicine : a journal of the British Diabetic Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 21 citations in OpenAlex.
- Review
- [Management of hyperglycemia in pregnancy (Update 2026)].Wiener klinische Wochenschrift · 2026Review
- Construction of a Risk Prediction Model and Associative Path Analysis for Impaired Awareness of Hypoglycemia in People with Diabetes.Diabetes, metabolic syndrome and obesity : targets and therapy · 2026Article
- Impaired awareness of hypoglycemia: can structured education address this persistent challenge?Frontiers in endocrinology · 2026Review
- EndoBridge 2024: pearls and highlights.Hormones (Athens, Greece) · 2025Article
- Prevalence and risk factors of fear of hypoglycemia (FOH) among diabetic pregnant women at King Abdulaziz Medical City- Jeddah (KAMC-J), Saudi Arabia.Journal of family medicine and primary care · 2025Article
- Addressing the Emotional Side of Diabetes During Pregnancy: A Scoping Review With Implications for Intervention.Diabetes spectrum : a publication of the American Diabetes Association · 2025Article
- Glycemic Profiles and Hypoglycemia Awareness Among Pregnant Women with Gestational and Pre-existing Diabetes Referred to a Tertiary Center in Sulaimaniyah-Iraq in 2024.International journal of endocrinology and metabolism · 2024Article
- Observational
- A review of CONCEPTT study findings including subanalyses in pregnant women using continuous glucose monitoring with type 1 diabetes and their offspring.Endocrine connections · 2024Review
- Current and future therapies to treat impaired awareness of hypoglycemia.Frontiers in pharmacology · 2023Review
- [Clinical practice recommendations for diabetes in pregnancy (Update 2023)].Wiener klinische Wochenschrift · 2023Article
- Impaired awareness of hypoglycaemia in women with type 1 diabetes in pregnancy: Hypoglycaemia fear, glycaemic and pregnancy outcomes.Diabetic medicine : a journal of the British Diabetic Association · 2022Article
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Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo examine maternal fear of hypoglycaemia, glycaemia and pregnancy outcomes in women with impaired and normal awareness of hypoglycaemia.
methodsA pre-planned sub-study of 214 pregnant women with type 1 diabetes who participated in the CONCEPTT trial. Participants completed hypoglycaemia fear surveys (HFS-II) at baseline. Logistic regression and Poisson regression analyses were used to obtain an adjusted estimate for the rate ratio relating awareness to the number of severe hypoglycaemic episodes, and for several neonatal outcomes in relation to the total HFS-II score. The role of continuous glucose monitoring (CGM) use was examined.
resultsOverall, 30% of participants reported impaired awareness of hypoglycaemia (n = 64). Women with impaired awareness of hypoglycaemia had more episodes of severe hypoglycaemia (mean 0.44 vs. 0.08, p < 0.001) (12-34 weeks gestation) and scored higher on the HFS-II scale (43.7 vs. 36.0, p 0.008), indicating more fear of hypoglycaemia. They spent more time below range (CGM <3.5 mmol/L) and exhibited more glycaemic variability at 12 weeks gestation. Higher overall HFS-II scores were associated with a higher risk of maternal severe hypoglycaemia episodes (Rate Ratio 1.78, 95% CI 1.39-2.27). Women with impaired awareness of hypoglycaemia had less maternal weight gain but there were no differences in neonatal outcomes between women with impaired awareness of hypoglycaemia and normal hypoglycaemia awareness. Higher HFS-II scores were associated with more nephropathy (Odds Ratio 1.91, 95% CI 1.06-3.4). CGM use after 12 weeks was not associated with the number of episodes of severe hypoglycaemia (RR 0.75, 95% CI 0.49-1.15; p = 0.18).
conclusionsIn pregnant women with type 1 diabetes, impaired awareness of hypoglycaemia is associated with more maternal severe hypoglycaemia episodes and more fear of hypoglycaemia. Having impaired awareness of hypoglycaemia and/or fear of hypoglycaemia should alert clinicians to this increased risk. Reassuringly, there was no increase in adverse neonatal outcomes.
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