The relation between HbA1c and hypoglycemia revisited; a secondary analysis from an intervention trial in patients with type 1 diabetes and impaired awareness of hypoglycemia.
J Diabetes Complications
; 32(1): 100-103, 2018 01.
Article
in En
| MEDLINE
| ID: mdl-29054335
ABSTRACT
AIMS:
We aimed to re-assess the previously shown but recently disputed association between HbA1c and severe hypoglycemia.METHODS:
52 Patients with T1D and IAH participated in an earlier reported randomized, crossover trial with two 16-week intervention periods comparing continuous glucose monitoring (CGM) with self-monitoring of blood glucose (SMBG). In this previous study, time spent in normoglycemia (the primary outcome), was improved by 9.6% (p<0.0001). We performed post-hoc analyses using a zero-inflated Poisson regression model to assess the relationship between severe hypoglycemia and HbA1c, glucose variability and duration of diabetes.RESULTS:
During SMBG use, HbA1c and the number of severe hypoglycemic events were negatively associated (OR 0.20 [95% CI 0.09 to 0.44]). During CGM use, this relationship showed an odds ratio of 0.65 (95% CI 0.42 to 1.01). There was no significant relationship between glucose variability or duration of diabetes and severe hypoglycemia.CONCLUSIONS:
In patients with T1D and IAH, treated with standard SMBG, a negative association exists between HbA1c and the number of severe hypoglycemic events. Thus, reaching target HbA1c values still comes with a higher risk of severe hypoglycemia. CGM weakens this association, suggesting CGM enables patients to reach their target HbA1c more safely.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Awareness
/
Glycated Hemoglobin
/
Diabetes Mellitus, Type 1
/
Hypoglycemia
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Diabetes Complications
Journal subject:
ENDOCRINOLOGIA
Year:
2018
Document type:
Article