Associations between the Time in Hypoglycemia and Hypoglycemia Awareness Status in Type 1 Diabetes Patients Using Continuous Glucose Monitoring Systems

Yu Kuei Lin, Danielle Groat, Owen Chan, Man Hung, Anu Sharma, Michael W. Varner, Ramkiran Gouripeddi, Julio C. Facelli, Simon J. Fisher

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Background: Continuous glucose monitoring (CGM) systems help reduce hypoglycemia in patients with type 1 diabetes (T1D). It remains unclear whether T1D patients with impaired awareness of hypoglycemia (IAH) continue to develop more hypoglycemia than those with normal hypoglycemia awareness (NA) despite CGM use. Materials and Methods: For this cross-sectional observational study, 99 T1D patients using real-time CGMs for ≥86% of time were recruited. Fifty and 49 patients were found to have NA and IAH (based on the Clarke questionnaire), respectively. Two-week CGM hypoglycemia data were collected. Results: IAH was associated with greater percentages of CGM values <70 and <54 mg/dL (P = 0.012, P = 0.004) compared to NA. Clarke scores correlated positively with the percentage of CGM values <70 and <54 mg/dL (P = 0.013, P = 0.004). IAH was also related to more events with glucose <70 and <54 mg/dL determined either with at ≥1 time point (P = 0.048, P = 0.003) or lasting ≥20 min (P = 0.016, P = 0.004). IAH patients presented with more day-time events with glucose <54 mg/dL (P = 0.015), nocturnal events with glucose levels <70 and <54 mg/dL (P = 0.009, P = 0.007) and longer day-time event duration with glucose levels <70 and <54 mg/dL (P < 0.001, P = 0.006), respectively. Conclusions: T1D patients with IAH continue to experience more hypoglycemia despite dedicated CGM use.

Original languageEnglish
Pages (from-to)787-793
Number of pages7
JournalDiabetes Technology and Therapeutics
Volume22
Issue number11
DOIs
StatePublished - Nov 2020

Bibliographical note

Publisher Copyright:
© 2020, Mary Ann Liebert, Inc., publishers.

Keywords

  • Continuous glucose monitoring
  • Hypoglycemia
  • Impaired awareness of hypoglycemia
  • Type 1 diabetes

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Medical Laboratory Technology

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