Clinically Serious Hypoglycemia Is Rare and Not Associated With Time-in-range in Youth With New-onset Type 1 Diabetes.
J Clin Endocrinol Metab
; 106(11): 3239-3247, 2021 10 21.
Article
en En
| MEDLINE
| ID: mdl-34265059
ABSTRACT
CONTEXT Early initiation of continuous glucose monitoring (CGM) is advocated for youth with type 1 diabetes (T1D). Data to guide CGM use on time-in-range (TIR), hypoglycemia, and the role of partial clinical remission (PCR) are limited. OBJECTIVE:
Our aims were to assess whether 1) an association between increased TIR and hypoglycemia exists, and 2) how time in hypoglycemia varies by PCR status.METHODS:
We analyzed 80 youth who were started on CGM shortly after T1D diagnosis and were followed for up to 1-year post diagnosis. TIR and hypoglycemia rates were determined by CGM data and retrospectively analyzed. PCR was defined as (visit glycated hemoglobin A1c)â +â (4*units/kg/day) less than 9.RESULTS:
Youth were started on CGM 8.0 (interquartile range, 6.0-13.0) days post diagnosis. Time spent at less than 70 mg/dL remained low despite changes in TIR (highest TIR 74.6â ±â 16.7%, 2.4â ±â 2.4% hypoglycemia at 1 month post diagnosis; lowest TIR 61.3â ±â 20.3%, 2.1â ±â 2.7% hypoglycemia at 12 months post diagnosis). No events of severe hypoglycemia occurred. Hypoglycemia was rare and there was minimal difference for PCR vs non-PCR youth (54-70 mg/dL 1.8% vs 1.2%, Pâ =â .04; <â 54mg/dL 0.3% vs 0.3%, Pâ =â .55). Approximately 50% of the time spent in hypoglycemia was in the 65 to 70 mg/dL range.CONCLUSION:
As TIR gradually decreased over 12 months post diagnosis, hypoglycemia was limited with no episodes of severe hypoglycemia. Hypoglycemia rates did not vary in a clinically meaningful manner by PCR status. With CGM being started earlier, consideration needs to be given to modifying CGM hypoglycemia education, including alarm settings. These data support a trial in the year post diagnosis to determine alarm thresholds for youth who wear CGM.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Glucemia
/
Biomarcadores
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Diabetes Mellitus Tipo 1
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Hipoglucemia
/
Hipoglucemiantes
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Child
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Female
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Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Clin Endocrinol Metab
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos