Analysis of real‐world capillary blood glucose data to help reduce HbA1c and hypoglycaemia in type 1 diabetes: Evidence in favour of using the percentage of readings in target and coefficient of variation
Authors' conclusion
HbA1c <58 mmol/mol (7.5%) is achievable even when only ~60% of CBG readings are between 3.9-10 mmol/L. Examining readings subsequent to out-of-range readings suggests useful behaviours which people with type 1 diabetes could be supported to adhere to, both in a clinic and structured education programmes, thereby decreasing the risk of hypoglycaemia whilst also reducing hyperglycaemia and improving HbA1c .
Study context
- Population
- Adults with T1D, real-world capillary blood glucose (CBG) datasplit into HbA1c quartiles
- Participants
- 682 adults
- Exposure
- HbA1c quartiles; re-testing within 30 min of hypoglycaemia vs not
- Outcome
- Proportions of CBG readings in different ranges at different HbA1c levels
Methodological detailsreal-world data, stratified by HbA1c quartile
- Real-world data
- Stratified by HbA1c quartile
Main finding
As reported in the abstract
CBG readings in target range (3.9-10 mmol/L)
P < 0.05
Observational data: associations, not effects.
Further findings
Hypoglycaemia by HbA1c quartile
- Hypoglycaemia often preceded by hyperglycaemia, and vice-versa; twice as likely in highest HbA1c quartile
Hypoglycaemia with re-testing within 30 min of hypoglycaemia
- Re-testing within 30 min of hypoglycaemia associated with less hypoglycaemia, 1.6% vs 7.2%; also reduces subsequent hyperglycaemia and further hypoglycaemia in the next 24 h
- P < 0.001
Glycaemic variability and hypoglycaemia
- CV (but not SD) highly associated with hypoglycaemia
- r = 0.71
- CV ≤ 36% equates to CBG readings in hypoglycaemic range
- 3.3%
Original publication
Analysis of real‐world capillary blood glucose data to help reduce HbA1c and hypoglycaemia in type 1 diabetes: Evidence in favour of using the percentage of readings in target and coefficient of variation. Diabet Med. Published 20 October 2022. doi:10.
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