316-OR: Interoception Predicts Impaired Awareness of Hypoglycemia (IAH) in Adults with Type 1 Diabetes (T1D)

Introduction: Recurrent hypoglycemia attenuates hypoglycemia symptoms, making symptom detection more challenging and leading to IAH. However, some with T1D maintain hypoglycemia awareness despite symptom attenuation. Interoception, or the ability to sense, interpret, and integrate internal somatic signals, may contribute to maintenance of hypoglycemia awareness. We sought to assess the association between interoception and IAH in adults with T1D. Methods: Adults (n = 154, 20% Black, 64% female) with T1D (mean ±SD age: 40 ±16 years, T1D duration: 23 ±14 years) completed the Clarke questionnaire (8-items scored 0-7; ≥ 4 indicates IAH), Gold Score (1 item scored 0-7; ≥ 4 indicates IAH), HypoA-Q Impaired Awareness scale (5-items scored 0-20; ≥ 12 indicates IAH) and Multidimensional Assessment of Interoceptive Awareness Version 2 (MAIA-2; 8 scales measuring 5 dimensions of body awareness; each scale scored 0-5; higher indicates greater interoceptive awareness). IAH was defined as ≥ 2 positive IAH measures. Logistic regression was performed, and odds ratios (OR) with 95% confidence intervals (CI) were calculated to assess the association between MAIA-2 scales and IAH controlling for disease duration, age, and recurrent severe hypoglycemia. Results: Seventeen percent of participants (n = 26) screened positive for IAH. Logistic regression revealed significant relationships between IAH and disease duration, recurrent severe hypoglycemia, and 2 MAIA-2 scales ("Attention Regulation" & "Not Worrying"). Each 1-point increase in "Attention Regulation" was associated with 72% decreased odds of IAH (OR: 0.28, CI: 0.12 - 0.66). Each 1-point increase in "Not Worrying" was associated with 87% increased odds of IAH (OR: 1.87, CI: 1.01 - 3.46). Conclusion: Those with T1D and IAH may have reduced ability to sustain and control attention to body sensations and less worry with sensations of discomfort. Research to better understand the relationship between interoception and IAH is warranted.