Relationship Between Sensor-Detected Hypoglycemia and Patient-Reported Hypoglycemia in People With Type 1 and Insulin-Treated Type 2 Diabetes: The Hypo-METRICS Study
Year: 2024
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: Use of continuous glucose monitoring (CGM) has led to greater detection of hypoglycemia; the clinical significance of this is not fully understood. The Hypoglycaemia-Measurement, Thresholds and Impacts (Hypo-METRICS) study was designed to investigate the rates and duration of sensor-detected hypoglycemia (SDH) and their relationship with person-reported hypoglycemia (PRH) in people living with type 1 diabetes (T1D) and insulin-treated type 2 diabetes (T2D) with prior experience of hypoglycemia. RESEARCH DESIGN AND METHODS: We recruited 276 participants with T1D and 321 with T2D who wore a blinded CGM and recorded PRH in the Hypo-METRICS app over 10 weeks. Rates of SDH <70 mg/dL, SDH <54 mg/dL, and PRH were expressed as median episodes per week. Episodes of SDH were matched to episodes of PRH that occurred within 1 h. RESULTS: Median [interquartile range] rates of hypoglycemia were significantly higher in T1D versus T2D; for SDH <70 mg/dL (6.5 [3.8-10.4] vs. 2.1 [0.8-4.0]), SDH <54 mg/dL (1.2 [0.4-2.5] vs. 0.2 [0.0-0.5]), and PRH (3.9 [2.4-5.9] vs. 1.1 [0.5-2.0]). Overall, 65% of SDH <70 mg/dL was not associated with PRH, and 43% of PRH had no associated SDH. The median proportion of SDH associated with PRH in T1D was higher for SDH <70 mg/dL (40% vs. 22%) and SDH <54 mg/dL (47% vs. 25%) than in T2D. CONCLUSIONS: The novel findings are that at least half of CGM hypoglycemia is asymptomatic, even below 54 mg/dL, and many reported symptomatic hypoglycemia episodes happen above 70 mg/dL. In the clinical and research setting, these episodes cannot be used interchangeably, and both need to be recorded and addressed.
Source: Diabetes Care
DOI: 10.2337/dc23-2332
Authors: Patrick Divilly, Gilberte Martine-Edith, Natalie Zaremba, Uffe Søholm, Zeinab Mahmoudi, Monika Cigler, Namam Ali, Evertine J. Abbink, Julie Brøsen, Bastiaan de Galan, Ulrik Pedersen-Bjergaard, Allan A. Vaag, Rory J. McCrimmon, Eric Renard, Simon Heller, Mark Evans, Julia K. Mader, Stephanie A. Amiel, Frans Pouwer, Pratik Choudhary
Institutions: University College Dublin, King's College London, St. Vincent's University Hospital, University of Southern Denmark, Novo Nordisk (Denmark), Novo Nordisk (United States), Medical University of Graz, Radboud University Nijmegen, Radboud University Medical Center, Copenhagen University Hospital, Maastricht University, University of Copenhagen, Steno Diabetes Center Copenhagen, University of Dundee, Centre National de la Recherche Scientifique, Inserm, Université de Montpellier, Centre Hospitalier Universitaire de Montpellier, Institut de Génomique Fonctionnelle, University of Sheffield, University of Cambridge, Wellcome/MRC Institute of Metabolic Science, University of Leicester
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Juvenile Diabetes Research Foundation International, Eli Lilly and Company, Sanofi, Leona M. and Harry B. Helmsley Charitable Trust, University of Dundee, European Federation of Pharmaceutical Industries and Associations, Steno Diabetes Center Copenhagen, National Institute for Health and Care Research, Department of Health and Social Care, University of Cambridge, King's College London, European Commission, Radboud Universiteit, Novo Nordisk, Université de Montpellier, Innovative Medicines Initiative, Abbott Diabetes Care, Menzies Centre for Australian Studies, King's College London, University of London, NIHR Cambridge Biomedical Research Centre
OpenAlex ID: W4401994999