New hypoglycemia guidelines define <70 mg/dl as a clinical alert for hypoglycemia and <54 mg/dl as clinically significant hypoglycemia. Fear of hypoglycemia is a significant barrier to increased time in range (TIR, 70-180 mg/dl). We examined the association between incidence of hypoglycemia and TIR and mean glucose (MG).
CGM data were collected from youth starting CGM within 1 month of a T1D diagnosis. For each patient, for each two-week period, TIR, MG, and percent time in hypoglycemia (Hyp) (<70) and clinically significant hypoglycemia (csHyp) (<54) were calculated. The associations between each of TIR, MG and each of Hyp and csHyp in each two-week period were modelled with multivariate linear regression, controlling for age, race, sex, insurance type, CGM wear time, and partial clinical remission status (Table 1).
In total, 1049 two-week periods from 51 patients were reviewed; 41% of these patients were female, the mean age was 9.4 years, and patients wore their CGMs an average of 89% within each two-week period. For csHyp, there was a non-significant negative association with TIR and a significant negative association with MG (p<0.001). For Hyp, there was a significant association with TIR and MG (Table 1).
We found no association between csHyp and TIR. These findings suggest that high TIR may be maintained without increasing csHyp. Further study should examine the use of CGM to improve TIR.
A. Gu: None. P. Prahalad: None. D.M. Maahs: Advisory Panel; Self; Eli Lilly and Company, Insulet Corporation, Medtronic, Novo Nordisk A/S. Consultant; Self; Abbott, Sanofi. Research Support; Self; Bigfoot Biomedical, Dexcom, Inc., Roche Diabetes Care, Tandem Diabetes Care. A. Addala: None. D. Scheinker: None.