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Gender differences in hypoglycaemia in type 1 and insulin-treated type 2 diabetes: the Hypo-METRICS study
Aisling McCarthy1, Gráinne Kent2, Jonah Thomas3
1Department of Medicine, University College Dublin, Dublin, Ireland. aisling.m.mccarthy@ucdconnect.ie.
Diabetologia
|June 20, 2026
Summary
Women with diabetes experience more frequent symptomatic hypoglycaemia than men, despite similar glucose level exposures. This study highlights gender-based differences in hypoglycaemia symptoms, particularly in type 1 diabetes.
Area of Science:
- Endocrinology
- Diabetes Research
- Clinical Medicine
Background:
- Hypoglycaemia is a common complication in insulin-treated diabetes.
- Understanding gender-specific experiences of hypoglycaemia is crucial for effective management.
- Previous research has not fully elucidated gender differences in real-world hypoglycaemia symptom reporting.
Purpose of the Study:
- To investigate associations between gender and the experience of hypoglycaemia.
- To compare hypoglycaemia symptoms and frequency between men and women with type 1 and type 2 diabetes.
- To analyze gender differences in a free-living environment using continuous glucose monitoring.
Main Methods:
- Prospective, cross-sectional observational study (Hypo-METRICS) over 10 weeks.
- Participants used blinded continuous glucose monitors (CGM) and a mobile app to record hypoglycaemia symptoms.
- Symptomatic hypoglycaemia defined as glucose <4 mmol/l or resolved symptoms; symptoms categorized as autonomic or neuroglycopenic.
Main Results:
- Women with type 1 diabetes reported more frequent symptomatic hypoglycaemia episodes per week (4.3 vs 3.3) compared to men.
- Women with type 2 diabetes also reported more frequent symptomatic episodes (1.4 vs 1.0) than men.
- No significant gender differences in time spent in hypoglycaemia were observed in either cohort, but symptom reporting varied.
Conclusions:
- Gender influences the experience of hypoglycaemia symptoms, even with similar glucose level exposures.
- Women reported a broader range of symptom combinations, including autonomic and neuroglycopenic symptoms.
- Further research is necessary to understand the underlying causes of these gender-based differences in hypoglycaemia symptom perception.
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