Identifying people at risk for severe hypoglycemia by CGM in a sample of people with reduced hypoglycemia awareness

  • It is well known that people with type 1 diabetes (pw1d) and hypoglycemia unawareness have an increased risk for severe hypoglycemia (SH); however, it is unknown if continuous glucose monitoring (CGM)helps to prospectively evaluate the risk of SH in such patients. We analyzed CGM recordings of 126 participants on MDI in the HypoDE study with hypoglycemia unawareness wearing blinded CGM (DexCom Gen 4) for 28 days (age 46.5±11.5 yrs. 36.5% female, HbA1c 7.5±1.0%, unawareness score 5.0±1.1). From these subjects, 65 (51.6%) reported occurrence of SH in the last year prior to study start. In a high-risk group of pw1d and hypoglycemia unawareness, CGM data on the exposure regarding hypoglycemic glucose values or number of hypoglycemic events ≤55 mg/dl predict the occurrence of SH. ROC analyses suggested meaningful cut-off values for the duration of hypoglycemic episodes, respectively the number of hypoglycemic events. These cut-off values can facilitate the identification of people with an elevated risk for SH even in a hypoglycemicIt is well known that people with type 1 diabetes (pw1d) and hypoglycemia unawareness have an increased risk for severe hypoglycemia (SH); however, it is unknown if continuous glucose monitoring (CGM)helps to prospectively evaluate the risk of SH in such patients. We analyzed CGM recordings of 126 participants on MDI in the HypoDE study with hypoglycemia unawareness wearing blinded CGM (DexCom Gen 4) for 28 days (age 46.5±11.5 yrs. 36.5% female, HbA1c 7.5±1.0%, unawareness score 5.0±1.1). From these subjects, 65 (51.6%) reported occurrence of SH in the last year prior to study start. In a high-risk group of pw1d and hypoglycemia unawareness, CGM data on the exposure regarding hypoglycemic glucose values or number of hypoglycemic events ≤55 mg/dl predict the occurrence of SH. ROC analyses suggested meaningful cut-off values for the duration of hypoglycemic episodes, respectively the number of hypoglycemic events. These cut-off values can facilitate the identification of people with an elevated risk for SH even in a hypoglycemic high-risk group with reasonable sensitivity and specificity.show moreshow less

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Metadaten
Institutes:Fakultät Humanwissenschaften / Lehrstuhl für Klinische Psychologie/Psychotherapie
Author:Norbert Hermanns, Guido Freckmann, Dominic Ehrmann, Peter Wintergerst, Gabriele Faber-Heinemann, Lutz Heinemann
Place of publication:Bamberg
Publisher:OPUS
Year of publication:2018
Pages / Size:1 pdf-Datei (1 S.)
Year of first publication:2017
Source/Other editions:Ursprünglich in: Diabetes : a journal of the American Diabetes Association 66 (2017) Suppl.1, A233 (906-P)
URL:https://opus4.kobv.de/opus4-bamberg/frontdoor/index/index/docId/52587
URN:urn:nbn:de:bvb:473-opus4-524113
DOI:https://doi.org/10.20378/irbo-52411
Document Type:Variety of texts
Language:English
Peer Review:Ja
Internationale Verbreitung:Ja
Open-Access-Zeitschrift:Nein
Publishing Institution:Otto-Friedrich-Universität Bamberg
Release Date:2018/07/30
Licence (German):License LogoDeutsches Urheberrecht