Background: Continuous glucose monitors (CGM) are the new standard for detecting hypoglycemia in T1D. No guidelines have been published that address monitoring during the return to euglycemia.
Methods: CGM data was gathered from 50 children and adolescents (ages 7-17) attending a week-long diabetes camp. All campers were treated according to camp protocol with 10-20g of carbohydrates depending on the size of the child and severity of hypoglycemia.
Results: 241 hypoglycemic events were analyzed using CGM data. 57 events had a nadir <54 mg/dl and 184 were 54 to <70 mg/dl. When measuring 15 min from the nadir, 89% of the <70 mg/dl group had risen above 70 mg/dl vs. only 47% of the <54 mg/dl group. During the day, a nadir <54 mg/dl took an average of 19 min to return to >70 mg/dl vs. 27 min at night. Nadirs <70 mg/dl took an average of 11 min during the day and 12 min at night to return to >70 mg/dl. Duration of hypoglycemia for nadirs <54 mg/dl vs. <70 mg/dl averaged 40 min vs. 18 min. Mean duration of hypoglycemia for the <54 mg/dl group was 35 min during the day vs. 49 min at night. Mean duration of hypoglycemia for the <70 mg/dl group was 18 min during the day and 20 min at night.
Conclusion: The depth of CGM hypoglycemia can help guide when to obtain a meter BG when treating hypoglycemia. If the glucose is <70 but >54 mg/dl, 89% will resolve within 15 min of the nadir; however less than 50% of those <54 mg/dl will have responded by 15 min and should have a meter BG if sensor is not >70 mg/dl at 15 min.
L.M. Norlander: None. K. Satam: None. S. Hanes: None. B.A. Buckingham: Advisory Panel; Self; ConvaTec Inc., Medtronic. Research Support; Self; Beta Bionics, Inc., Dexcom, Inc., Insulet Corporation, Medtronic, Tandem Diabetes Care.