We performed quantified glycemic variability using continuous glucose monitoring (CGM) in people with T2DM at high (n=10) or low (n=8) 5-year risk for hypoglycemia to examine if high 5 year risk for hypoglycemia was associated with more short-term (2 weeks) glycemic variability and hypoglycemia.

Methods: Participants with T2DM [10W/8M, mean(SD): age: 59.5 (12.3) years], HbA1c: 7.6% (1.3%), fructosamine: 303 (46) umol/l] were preclassified as high or low 5 year risk for hypoglycemia. Each participant wore 2 blinded CGMs (1 Freestyle LibrePro/arm) for 2 weeks.

Results: HbA1c and fructosamine did not differ between groups. (Table1) The test/retest coefficient of variation (CV) measures the variation between glucose variability metrics from two sensors on the same person, adjusted for the mean of a given metric. The 2 sensors had the strongest test-re-test (<0.1) for CV, SD, Mean, and MODD. In both the high and low risk group, HbA1c correlated with glycemic measures (r:0.4 to 0.7). In the low risk group, fructosamine (r:0.6 to 0.9) correlated with glycemic measures better than HbA1c.

Conclusions: Regardless of 5 year risk status, short-term hypoglycemia was infrequent and not different between groups. Hba1c and fructosamine correlated with glycemic variability. Glycemic variability was less in the low risk than high risk group, supporting that high glucose (≥180 mg/dL) drives much of the glycemic variability in T2DM.


E.A. Olawsky: None. Y. Zhang: None. A.C. Alvear: None. L.E. Eberly: None. L.S. Chow: None.


Academic Health Center (FRD17.08); National Institutes of Health (UL1TR002494)

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