Grant: Project Grant

People living with type 1 diabetes (PWT1D) cannot produce insulin, necessitating lifelong, intensive insulin replacement therapy. PWT1D strives for achieving blood sugar levels as close to normal as possible to prevent severe complications like blindness and amputation. Hypoglycemia (low blood sugar) is the most frequent complication of insulin therapy with over 2 episodes per person per week. It hinders the attainment of glucose targets, disrupts daily functioning, and results in malaise, loss of consciousness, convulsions, and fear. In most cases, the current recommended treatment of 15g of sugar for hypoglycemia is evidently insufficient. PWT1D's main focus remains on reducing hypoglycemia, despite advancements such as continuous glucose monitoring (CGM: estimates blood glucose in real-time conditions) replacing traditional finger pricks and artificial pancreas systems enabling automated insulin delivery. The existing guidelines for treating hypoglycemia were established in the 1980s and propose waiting for its occurrence before administering 15g of sugar every 15 minutes until the hypoglycemia is corrected. In a study co-designed with PWT1D, we propose a paradigm shift from always treating hypoglycemia with the same approach to preventing hypoglycemia with individualized guidance. Our goals are to explore whether pre-emptive treatment before reaching the hypoglycemia threshold can prevent hypoglycemia and the need for repeated treatments, we will also explore how much sugar should be taken. By providing guidance on when to act and how much sugar to consume, we aim to reduce the frequency and burden of hypoglycemia while enhancing safety and overall quality of life for PWT1D.