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RATES OF SENSOR DETECTED HYPOGLYCAEMIA AND PATIENT REPORTED HYPOGLYCAEMIA; PRELIMINARY DATA FROM THE HYPO-METRICS TRIAL
Abstract
Background and Aims
Many hypoglycaemic episodes detected by continuous glucose monitoring (CGM) are asymptomatic. The HypoMETRICS study aims to understand the impact of symptomatic and asymptomatic sensor-detected hypoglycaemia (SDH). We report preliminary study data on rates of SDH and patient-reported hypoglycaemia (PRH).
Methods
We recruited people with insulin-treated diabetes who had experienced >1 hypoglycaemic episode in the last month and were hypoglycaemia aware by Gold score. Participants continued their usual method of glucose monitoring, with blinded CGM and recorded episodes of PRH in real-time through a purpose-built smartphone app for 10 weeks. PRH was defined as symptomatic episodes that resolved on carbohydrate ingestion, or a self-measured glucose <4 mmol/l (72mg/dl).
Results
The present analysis includes 105 participants (81 type 1 diabetes, 24 type 2 diabetes), mean (SD) age 49.1(15.9) years, diabetes duration 20.8(13.3) years, 63 using Flash and 4 using CGM. Mean time in range was 60(14.4) %, with time below 3.9mmol (70mg/dl) 4.7(3.9) %; time below 3mmol(54mg/dl) at 1.1(1.5) %. There were 7132 and 1931 level 1 and level 2 hypoglycaemic episodes with a mean rate 6.8(4.1) and 1.8(1.8) episodes/week respectively. Prolonged hypoglycaemia (below 3mmol for >2hours) accounted for 8% of level 2 hypoglycaemia, with 0.2 (0.4) episodes/week. Participants recorded 3,967 PRHs at 3.8(3.1) episodes/week.
Conclusions
As rates of SDH at 3.9mmol were 80% higher than PRH, this would suggest significant asymptomtic hypoglycaemia, even in people with hypoawareness intact. Using sensor data alone to judge awareness should be done with caution.