ArticleEClinicalMedicine2023
Effect of diabetes technologies on the fear of hypoglycaemia among people living with type 1 diabetes: a systematic review and meta-analysis.
Article in EClinicalMedicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Pooled it
- Impact of the initiation of isCGM soon after type 1 diabetes mellitus diagnosis in adults on glycemic indices and fear of hypoglycemia: a randomized controlled trial.Frontiers in endocrinology · 2024Trial
- Work productivity and psychological well-being in patients affected by type 1 diabetes mellitus.Internal and emergency medicine · 2026Article
- From narratives to numbers and back: Assessing the psychosocial aspects of diabetes in the era of high technology with emerging qualitative and quantitative methodologies.Diabetic medicine : a journal of the British Diabetic Association · 2026Review
- 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- Understanding the Increasing Prevalence of Obesity in Patients With Type 1 Diabetes: Strategies for Improving Clinical Care.Obesity (Silver Spring, Md.) · 2025Review
- Unveiling the Therapeutic Potential of the Second-Generation Incretin Analogs Semaglutide and Tirzepatide in Type 1 Diabetes and Latent Autoimmune Diabetes in Adults.Journal of clinical medicine · 2025Review
- Article
- 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2025.Diabetes care · 2025Review
- Criteria for Personalised Choice of a Continuous Glucose Monitoring System: An Expert Opinion.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2024Article
- Review
- Effect of automated insulin delivery systems on person-reported outcomes in people with diabetes: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Clinical Usage and Potential Benefits of a Continuous Glucose Monitoring Predict App.Journal of diabetes science and technology · 2024Article
- Fear of Hypoglycemia and Diabetes Distress: Expected Reduction by Glucose Prediction.Journal of diabetes science and technology · 2024Article
- Exploring Technology's Influence on Health Behaviours and Well-being in Type 1 Diabetes: a Review.Current diabetes reports · 2024Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Fear of hypoglycaemia (FOH) significantly disrupts the daily management of type 1 diabetes (T1D) and increases the risk of complications. Recent technological advances can improve glucose metrics and reduce hypoglycaemia frequency, yet their impact on FOH is unclear. This systematic review and meta-analysis (SRMA) aimed to synthesize the current literature to understand the impact of diabetes technologies on FOH in T1D. Methods: In this SRMA, we searched PubMed, Medline, Scopus, and Web of Science from inception up to May 21st, 2023 for studies assessing the effect of using real-time or intermittently scanned continuous glucose monitors (rtCGM or isCGM); insulin pumps (CSII); and their combinations on FOH as the primary outcome, measured using the Hypoglycaemia Fear Survey (HFS; including total, worries [HFS-W], and behaviours [HFS-B] scores), in non-pregnant adults with T1D. Data was extracted by the first and second authors. Results were pooled using a random-effects model based on study design (RCT and non-RCT), with subgroup analysis based on the type of technology, reported change in hypoglycaemia frequency, and duration of use. Risk of bias was evaluated with Cochrane and Joanna Briggs Institute tools. This study is registered with PROSPERO, CRD42021253618. Findings: A total of 51 studies (n = 8966) were included, 22 of which were RCTs. Studies on rtCGM and CSII reported lower FOH levels with ≥8 weeks of use. Studies on CSII and rtCGM combinations reported lower FOH levels after ≥13 weeks of automated insulin delivery (AID) use or 26 weeks of sensor-augmented pump (SAP) use. The meta-analysis showed an overall lower FOH with technologies, specifically for the HFS-W subscale. The RCT meta-analysis showed lower HFS-W scores with rtCGM use (standard mean difference [95%CI]: -0.14 [-0.23, -0.05], I Interpretation: We found consistent, yet small to moderate, effects supporting that diabetes technologies (specifically rtCGM, SAP, and AID) may reduce hypoglycaemia-related worries in adults with T1D. Current literature, however, has limitations including discrepancies in baseline characteristics and limited, mainly descriptive, statistical analysis. Thus, future studies should assess FOH as a primary outcome, use validated surveys, and appropriate statistical analysis to evaluate the clinical impacts of technology use beyond just glucose metrics. Funding: Canadian Institutes of Health Research, Juvenile Diabetes Research Foundation Ltd.
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Registered trials
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