Restoring awareness of low blood sugar in type 1 diabetes
Official title: Restoring awareness of hypoglycemia in type 1 diabetes
Funded at University of Pennsylvania · NIH-11319767 · Data updated 2026-11-12
This project tests whether education, hybrid closed-loop insulin pumps, and small doses of glucagon can help adults with long-standing type 1 diabetes regain warning signs of low blood sugar.
Quick facts
| Grant type | U01 cooperative agreement |
|---|---|
| Study type | NIH-funded research |
| Funding institution | University of Pennsylvania NIH-funded |
| Lab location | 1 site (Philadelphia, United States) |
| Project start | September 25, 2022 |
| Project end | December 31, 2027 |
| Funding year | 2026 |
| Award (this year) | $731,968 |
| NIH project number | 5U01DK135120-04 |
| Project ID | NIH-11319767 on NIH RePORTER |
Who could benefit from this research
✓Could help
Adults (21+) with long-standing type 1 diabetes who have impaired awareness of hypoglycemia or frequent problematic low blood sugars are the intended candidates.
✕Less likely to help
People who already notice low-blood-sugar symptoms normally, have type 2 diabetes, or cannot use closed-loop devices or glucagon for medical reasons are unlikely to benefit from this specific program.
What this research studies
Over 24 months you'll take part in an adaptive randomized program where your assigned treatment can change based on how you respond. Options include standard hypoglycemia-avoidance education, using an automated hybrid closed-loop insulin delivery system, and taking mini-doses of glucagon. Researchers will measure hormonal and symptom responses using controlled low-blood-sugar tests (hypoglycemic clamps) and track your real-world glucose data to see which approaches restore warning signs. The goal is to learn which people benefit from which treatments so dangerous lows can be prevented more reliably.
Why it matters
Potential benefit: If successful, this work could lower the risk of severe low-blood-sugar episodes and make tighter blood-sugar control safer for people with type 1 diabetes.
How similar studies have gone: Previous studies show education and automated insulin delivery can reduce hypoglycemia, but combining an adaptive trial with mini-dose glucagon and detailed clamp testing to restore physiological warning responses is relatively new.
Where this research is happening
-
University of Pennsylvania
Philadelphia, United States Active
Researchers
- Principal investigator: Rickels, Michael R — University of Pennsylvania
- Study coordinator: Rickels, Michael R
Related research
Other NIH-funded projects on the same topics.
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Technological and Educational Approaches to Restore Hypoglycemia Awareness in Type 1 Diabetes
A two-arm study in adults with type 1 diabetes tests whether high-tech glucose control plus education or targeted training can help people regain awareness of low blood sugar.
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Techniques for restoring awareness of low blood sugar in adults with type 1 diabetes
A randomized trial compares different approaches to help adults with type 1 diabetes recognize when their blood sugar is dipping so they can act quickly.
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Treating impaired hypoglycemia awareness in type 1 diabetes with targeted education and technology
This study tests two treatment approaches to help adults with type 1 diabetes who often don’t realize their blood sugar is getting too low, using a mix of technology and education in two large groups.
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Helping people with type 1 diabetes regain awareness of dangerous lows
A UK study tests two different approaches to help adults with type 1 diabetes recognize and respond to low blood sugar by comparing a high-tech insulin system with targeted education.
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Understanding how hypoglycemia awareness changes in adults with type 1 diabetes and how automated insulin delivery and exercise might help restore it
This study will look at adults with type 1 diabetes to see how their awareness of low blood sugar evolves over time and whether automated insulin delivery and high-intensity exercise can help restore that awareness.
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Understanding how impaired hypoglycemia awareness develops in type 1 diabetes and how automated insulin delivery and exercise might help restore it
This study looks at adults with type 1 diabetes who struggle to sense hypoglycemia and tests whether automated insulin delivery and exercise can help restore their awareness.
About this research
- This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
- Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
- For full project details, budget, and progress reports, visit the official NIH RePORTER page.