Hypoglycaemia Unawareness — RACP Adult Medicine MCQ

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HardEndocrinology & DiabetesHypoglycaemia UnawarenessRACP Adult Medicine

A 45-year-old woman with type 1 diabetes on an insulin pump presents with recurrent hypoglycaemia (blood glucose <3.0 mmol/L) without typical warning symptoms. She has impaired awareness of hypoglycaemia. What technology is most effective for reducing severe hypoglycaemia?

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Correct answer: C — Continuous glucose monitoring with predictive low-glucose suspend (hybrid closed-loop/AID system)

Automated insulin delivery (AID/hybrid closed-loop) systems, which integrate CGM with insulin pump delivery and automated basal rate adjustment (including predictive low-glucose suspend), are the most effective technology for reducing severe hypoglycaemia in patients with impaired hypoglycaemia awareness. They reduce time below range and improve HbA1c. These systems are PBS-subsidised for eligible patients in Australia.

Reference: ADS – 2024 – Technology for Diabetes Management; eTG – 2025 – Endocrinology