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Type 1 diabetes with recurrent hypoglycaemia — SCE Endocrinology MCQ

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HardDiabetesType 1 diabetes with recurrent hypoglycaemiaSCE Endocrinology

A 29-year-old woman with type 1 diabetes uses multiple daily injections and flash glucose monitoring. She has recurrent nocturnal hypoglycaemia despite carbohydrate-counting education and careful basal dose reductions. Her time-below-range remains 9% and she is fearful of sleeping alone. What is the most appropriate management?

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Correct answer: D — Offer hybrid closed-loop insulin delivery if eligibility criteria are met

Persistent disabling hypoglycaemia despite structured education and technology support is a scenario in which hybrid closed-loop therapy should be considered under NICE technology guidance. Sulfonylureas and premixed insulin would increase hypoglycaemia risk in type 1 diabetes. The pearl is that technology questions often test a failure of optimised conventional treatment, not the first clinic visit.

Reference: NICE TA943, NICE NG17