A cross-sectional observational cohort analysis was conducted to assess whether higher hypoglycemia alarm thresholds on CGMs are associated with less hypoglycemia for both patients with normal (NAH) and impaired (IAH) awareness of hypoglycemia. Two-week CGM alarm/glucose data from 39 and 42 type 1 diabetes (T1D) patients with NAH and IAH (determined by the Clarke questionnaire) who have used CGMs for >3 months and had an active CGM usage time of ≥86% were included in the analysis. IAH patients with higher hypoglycemia alarm thresholds (i.e., alarm thresholds set >73 mg/dL vs. <73 mg/dL) spent 57.8% and 75.6% less time with glucose <70 and <54 mg/dL, respectively, while no significant differences were found between higher/lower alarm thresholds in the NAH groups. (Figure 1a, 1b) Fewer day and night-time numbers of hypoglycemic episodes (defined as ≥1 glucose value <70 and <54 mg/dL; Figure 1c, 1d) and shorter duration of episodes with glucose <54 mg/dL (Figure 1e, 1f) contributed to the reduced time spent in hypoglycemia in the IAH patients with higher alarm thresholds. The current analysis suggests that higher CGM hypoglycemia alarm thresholds are associated with less time spent in hypoglycemia in T1D patients with IAH, but not those with NAH.
Y. Lin: None. D. Groat: None. O. Chan: None. R. Pop-Busui: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc. Consultant; Self; Bayer Healthcare Pharmaceuticals Inc., Novo Nordisk Inc. Research Support; Self; AstraZeneca. Other Relationship; Self; American Diabetes Association. M. Varner: None. S. Fisher: None.
National Institute for Diabetes and Digestive and Kidney Diseases/Washington University School of Medicine (2P30DK020579); University of Utah Diabetes and Metabolism Research Center; National Institute for Diabetes and Digestive and Kidney Diseases (5T32DK091317); National Center for Advancing Translational Sciences (1ULTR002538)