ArticleDiabetes care2026
Interoceptive Awareness Moderates the Relationship Between Hypoglycemia Exposure and Symptom Recognition in Adults With Type 1 Diabetes.
Article in Diabetes care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Gender differences in hypoglycaemia in type 1 and insulin-treated type 2 diabetes: the Hypo-METRICS study.Diabetologia · 2026Observational
- Gold and Clarke Questionnaires Identify Different People With Insulin-Treated Diabetes and Impaired Awareness of Hypoglycaemia in Almost 60% of Cases: A Post Hoc Analysis From the Hypo-METRICS Study.Diabetes, obesity & metabolism · 2026Article
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Authors and funding
8 authors.
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Abstract
objectiveHypoglycemia exposure lowers the glycemic threshold for symptom recognition, contributing to impaired awareness of hypoglycemia (IAH). Interoceptive awareness, the ability to sense and interpret internal bodily sensations, is associated with a lower risk of IAH. We tested the hypothesis that interoceptive awareness moderates the association between hypoglycemia exposure and glycemic threshold for autonomic symptom recognition. RESEARCH DESIGN AND
methodsAdults with type 1 diabetes completed validated surveys assessing interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness, Version 2 [MAIA-2]) and the glycemic threshold for autonomic symptom recognition (Hypoglycemia Awareness Questionnaire Symptom Level subscale) and provided 30-day continuous glucose monitoring data. We used proportional odds logistic regression to examine whether the MAIA-2 Attention Regulation scale score (measuring the ability to sustain and control attention to bodily sensations) moderated the association between hypoglycemia exposure (percent time [%-time] <60 mg/dL) and symptom level, adjusting for covariates.
resultsAmong 717 participants (94% White, 52% female, mean [SD] age 44 [15] years; diabetes duration 25 [15] years; 17% with IAH), 30-day hypoglycemia exposure (%-time <60 mg/dL) was 0.8 (1.4%) (11.5 [20.2] min/day). Higher hypoglycemia exposure was associated with lower symptom levels (odds ratio [OR] 0.45; 95% CI 0.31, 0.66; P < 0.001). Interoceptive awareness alone was not associated with symptom level (OR 0.93; 95% CI 0.78, 1.12), but higher interoceptive awareness attenuated the association between hypoglycemia exposure and symptom level (OR 1.14; 95% CI 1.01, 1.27; P < 0.05).
conclusionsInteroceptive awareness moderated the association between hypoglycemia exposure and glycemic threshold for symptom recognition. Research is needed to examine whether interventions can improve interoceptive awareness and, thereby, restore awareness of hypoglycemia.
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