Evidence map›Paper›PMID 42118187›Full record

ArticleJournal of general internal medicine2026

Preventing Severe Hypoglycemia in Type 2 Diabetes: Randomized Controlled Trial of Proactive Care With Versus Without Psychoeducation.

James D Ralston, Melissa L Anderson, Janet Ng, Ayat Bashir, Kelly Ehrlich, Dena Burns-Hunt, Meredith Cotton, Laurel Hansell, Clarissa Hsu, Helen Hunt and 14 more

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04863872 (Comparing the Effectiveness of Two Approaches to Preventing Severe Hypoglycemia), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

NCT04863872 nacompletednot on this map

Comparing the Effectiveness of Two Approaches to Preventing Severe Hypoglycemia

TypeinterventionalSponsorKaiser PermanenteRan2022 to 2024Enrolled259ConditionsSevere HypoglycemiaArmsProactive Care Management, MyHC-T2D education program
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

James D RalstonKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA. james.d.ralston@kp.org.ORCID http://orcid.org/0000-0001-6317-7987
Melissa L AndersonKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA.
Janet NgKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA.
Ayat BashirTranslational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
Kelly EhrlichKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA.
Dena Burns-HuntKaiser Permanente Washington, 2715 Naches Ave SW, Renton, WA, 98057, USA.
Meredith CottonKaiser Permanente Washington, 2715 Naches Ave SW, Renton, WA, 98057, USA.
Laurel HansellKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA.
Clarissa HsuKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA.
Helen HuntKaiser Permanente Washington, 2715 Naches Ave SW, Renton, WA, 98057, USA.
Andrew J KarterDepartment of Research, Kaiser Permanente Northern California, 4480 Hacienda Drive, Pleasanton, CA, USA.
Shaula M LevyKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA.
Evette LudmanKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA.
Lawrence MadziwaKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA.
Emily M OmuraWashington Permanente Medical Group, 125 16th Ave E, Seattle, WA, USA.
Kristine RogersKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA.
Brandie SeveyKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA.
James A M ShawTranslational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.
Susan M ShortreedKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA.
Jane SpeightSchool of Psychology | Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.
Amber SweenyKaiser Permanente Washington, 2715 Naches Ave SW, Renton, WA, 98057, USA.
Katherine TschernischKaiser Permanente Washington, 2715 Naches Ave SW, Renton, WA, 98057, USA.
Sergei TschernischKaiser Permanente Washington, 2715 Naches Ave SW, Renton, WA, 98057, USA.
Laura YarboroughKaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Seattle, WA, 98101, USA.

Funding

Patient-Centered Outcomes Research Institute IHS-2019C3-17889
6 · The paper itself

Abstract

backgroundSevere hypoglycemia is a feared complication of diabetes treatment. While psychoeducational programs reduce severe hypoglycemia in type 1 diabetes, their effectiveness is unclear in type 2 diabetes (T2D). OBJECTIVE AND

designThe Preventing Severe Hypoglycemia in Adults with Type 2 Diabetes (PHT2) randomized trial compared (a) proactive nurse care management (PC) and (b) PC augmented with my hypo compass for adults with T2D, a psychoeducational intervention (PC+).

participantsAdults with T2D on insulin or sulfonylurea and with a severe event in the prior 12 months or impaired awareness of hypoglycemia. MAIN MEASURES: Primary outcome was self-reported severe hypoglycemia over 12 months, assessed at 14 months. KEY

resultsNinety-two percent (n = 230) of 259 participants (67.2 ± 10.6 years; 61% women) completed the trial. The proportion reporting ≥ 1 severe hypoglycemia event in the 12 months before baseline was 34.1% in the PC arm and 24.8% in the PC + arm. At 14 months, severe hypoglycemia did not differ significantly between arms (16.1% PC vs 11.6% PC + ; adjusted relative risk [aRR] 0.72 [95% confidence interval, 0.39 to 1.30]; adjusted absolute risk difference [aARD] -4.6 [95% confidence interval, -13.0 to 3.7]). Level 2 hypoglycemic events (glucose < 54 mg/dL for ≥ 15 min) were less frequent in the PC+ arm on the absolute risk scale but not on the relative risk scale (aRR 0.46 [95% confidence interval, 0.20 to 1.03]; aARD, -11.3% [95% confidence interval, -21.7 to -0.8]). No other secondary measures differed significantly between arms.

conclusionsAdding psychoeducational training to proactive care did not significantly reduce self-reported severe hypoglycemia compared to proactive care alone, with both groups experiencing a 50% reduction in severe hypoglycemia. Results should be interpreted with caution due to limited power.

trial registrationClinicalTrials.gov Identifier: NCT04863872.

Indexed as

diabetes mellitus type 2hypoglycemiarandomized controlled trial

Identifiers

PMID42118187

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