Document is current

Article History

Received: 12 January 2026

Accepted: 16 April 2026

First Online: 20 June 2026

Ethics

Acknowledgements: The authors thank the people living with diabetes who participated in the Hypo-METRICS study. The authors also thank the Hypo-RESOLVE consortium: M. L. Evans, D. Chapman and J. Kennet (University of Cambridge); B. E. de Galan (Maastricht University); S. Heller, S. Caunt, S. Hudson, C. Husband and F. Arshad (University of Sheffield); R. J. McCrimmon, A. Barnett and J. Lindsay (University of Dundee); U. Pedersen-Bjergaard (University of Copenhagen); E. Renard, A. Farret, A. M. Marteil-Oudrer, M. Shbat, L. Crespy and J. Constanza Thibout (University of Montpellier); A. Pernet, A. Aldridge and M. Henderson-Wilson (King’s College London); A. A. Vaag (Steno Diabetes Centre); P. Banck-Petersen, R. Carstensen and C. Hansen (Nordsjællands Hospital Hillerød); A. Rasing, J. Walburgh Schimidt, D. Loewenstein, R. Huijsmans, N. Ali, E. J. Abbink and P. Drijver (Radboud University Medical Centre); Z. Mahmoudi (University of Leicester); M. Cigler (Medical University of Graz); and J. Brøsen (Copenhagen University Hospital). The authors also thank Abbott Diabetes Care for providing the CGM devices used in the study and uMotif Limited for providing the platform for the Hypo-METRICS app. Some of the data included in this paper have been presented as abstracts at the Irish Endocrine Society Annual Meeting in 2025 and the Advanced Technologies and Treatments for Diabetes Meeting in 2026.

Data availability: Data are accessible by application to the Hypo-RESOLVE data access committee (Pratik Choudhary [pratik.choudhary@leicester.ac.uk] or Bastiaan de Galen [Bastiaan.deGalan@radboudumc.nl]). Restrictions apply to the use of these data in accordance with participant consent, privacy regulations and data-sharing agreements.

Funding: Hypo-RESOLVE received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement no. 777460 for the Hypo-METRICS study. The funder had no role in project design, data collection or analysis, manuscript development, or the decision to submit for publication. AM is supported by funding grants from St Vincent's Private Hospital, Dublin, and St Columcille's Hospital, Dublin, via the Newman fellowship.

Authors’ relationships and activities: SAA has served on advisory boards for Novo Nordisk and Medtronic and has spoken at educational events sponsored by Novo Nordisk and Sanofi. PC has received personal fees from Abbott Diabetes Care, Insulet, Dexcom, Novo Nordisk, AstraZeneca, Medtronic, Roche Diabetes Care and Sanofi Diabetes, and research funding support from Abbott Diabetes Care, Medtronic and Novo Nordisk. PD has spoken at education events sponsored by Novo Nordisk. JKM is a member of the advisory boards of Boehringer Ingelheim, Eli Lilly, Medtronic, Novo Nordisk AS, Prediktor A/S, Roche Diabetes Care and Sanofi-Aventis Deutschland GmbH, and has received speaker honoraria from Abbott Diabetes Care, AstraZeneca, Dexcom, Eli Lilly, Medtronic, MSD, Novo Nordisk AS, Roche Diabetes Care, Sanofi, Servier and Takeda. She is a shareholder of decide Clinical Software GmbH and elyte diagnostics. FP has received funding for research from Novo Nordisk, Eli Lilly and Sanofi-Aventis Deutschland GmbH. The remaining authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.

Contribution statement: All authors made substantial contributions to the conception and design of this manuscript. AM, PD, GK and PC developed the plan for this manuscript, with input and advice from the remaining co-authors. JT, GME, EA and NZ advised on the analysis plan, and AM conducted all analyses. AM prepared the first manuscript draft, with critical feedback from PD, PC, SAA, JKM and FP. AM prepared subsequent revisions with feedback from all authors. All authors approved the final draft of the manuscript. AM is the guarantor of this work and takes responsibility for the integrity of the data and the accuracy of the data analysis.