Ahmadi SS, Westman K, Pivodic A, et al. - Recent guidelines emphasize that individuals with type 1 diabetes should spend < 4.0% per day with glucose levels < 3.9 mmol/L (< 70 mg/dL) and < 1.0% per day with glucose levels < 3.0 mmol/L (< 54 mg/dL). Via performing GOLD randomized crossover trial including 161 individuals with type 1 diabetes treated with multiple daily insulin injections (MDI), researchers examined the correlation between time spent in hypoglycemia and various mean glucose and HbA1c levels. Participants received continuous glucose monitoring (CGM) or conventional therapy with self-monitoring of blood glucose (SMBG). During both CGM and conventional therapy, they noted significantly increased time spent in hypoglycemia (< 3.9 mmol/L and < 3.0 mmol/L) with lower mean HbA1c and mean glucose levels. Observations suggest that for type 1 diabetes patients treated with MDI, attaining current targets for time in hypoglycemia while at the same time attaining HbA1c targets is challenging both with CGM and SMBG monitoring. However, there was association of CGM with considerably less time in hypoglycemia than SMBG at a broad range of HbA1c levels and thus CGM is pivotal for patients with MDI treatment if they are to have a chance to approach hypoglycemia targets.