Flatt AJS, Little SA, Speight J, et al. - Researchers conducted this HypoCOMPaSS study to explore connections between baseline features and recurrent severe hypoglycemia over 2 years of follow-up. In total, 96 adults with T1D and impaired awareness of hypoglycemia partook in a 24-week 2 × 2 factorial randomized controlled trial comparing insulin delivery and glucose monitoring modalities, with the purpose of rigorous biochemical hypoglycemia avoidance. Seventy-one participants who had experienced severe hypoglycemia in the 12-month prestudy with confirmed absence (complete responder) or presence (incomplete responder) of severe hypoglycemia over 24 months of follow-up were included. Incomplete responders spent no more time with glucose ≤ 3 mmol/L at 24 months, with reduced total daily insulin dose and higher awareness of hypoglycemia. Findings suggested an association of recurrent severe hypoglycemia with higher preintervention severe hypoglycemia rate, fear of hypoglycemia, and concomitant neuropathy. In incomplete responders, peripheral neuropathy was more common with a trend toward increased autonomic neuropathy.