medwireNews: Early findings from the Hypo-METRICS trial indicate that people with diabetes are unaware on most of the occasions that their blood glucose dips into the hypoglycemic range.
Presenting the data at the ATTD meeting in Barcelona, Spain, Patrick Divilly (King’s College London, UK) said that the aim of Hypo-METRICS, which is part of the multinational Hypo-RESOLVE study, is to determine the glucose level and duration of hypoglycemia at which people with diabetes become aware of the event.
For this preliminary analysis, he reported data on 312 people with type 1 (57.1%) or type 2 (42.9%) diabetes, who undertook blinded continuous glucose monitoring for 10 weeks, during which they also recorded all episodes of symptomatic hypoglycemia in an app as they occurred.
The researchers found that there were many more events recorded by the glucose monitors than reported by the participants, at 19,335 versus 8880. Divilly noted that the relatively high number of events identified may be partly specific to the Hypo-METRICS study population, all of whom had experienced at least one hypoglycemic event in the 3 months before enrollment.
The study participants were an average age of 56 years and 86% were White. The majority (71%) had impaired awareness of hypoglycemia, about 60% were using a form of continuous glucose monitoring, and nearly a quarter had an insulin pump.
Divilly added that there were relatively few prolonged hypoglycemic events (n=447) or events where blood glucose fell below 2.2 mmol/mol (40 mg/dL; n=216).
Of the recorded events where blood glucose fell below 3.9 mmol/L (70 mg/dL), a median of just 23.8% matched with a person-reported event (with a 1-hour margin for error), with medians of 30.1% and 14.6% for those with type 1 and type 2 diabetes, respectively.
For blood glucose levels below 3.0 mmol/L (54 mg/dL), the team matched a median of 33.3% events overall, and a median of 33.3% and 14.6% that occurred in people with type 1 and type 2 diabetes, respectively.
These results highlight “that the majority of sensor-detected hyperglycemic events are asymptomatic with current definitions,” concluded Divilly.
He noted that the Hypo-METRICS study will also investigate whether asymptomatic hypoglycemic events are detrimental for people with diabetes.
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