Relationship Between Sensor-Detected Hypoglycemia and Patient-Reported Hypoglycemia in People With Type 1 and Insulin-Treated Type 2 Diabetes: The Hypo-METRICS Study
Authors' conclusion
The novel findings are that at least half of CGM hypoglycemia is asymptomatic, even below 54 mg/dL, and many reported symptomatic hypoglycemia episodes happen above 70 mg/dL. In the clinical and research setting, these episodes cannot be used interchangeably, and both need to be recorded and addressed.
Study context
- Population
- People with T1D or insulin-treated T2D with prior experience of hypoglycemia, wearing blinded continuous glucose monitoring (CGM) and recording person-reported hypoglycemia (PRH) in the Hypo-METRICS app over 10 weeks
- Participants
- 276 vs 321
- Exposure
- T1D vs insulin-treated T2D
- T1Dn = 276
- T2Dn = 321reference
- Outcome
- Rates of sensor-detected hypoglycemia (SDH) <70 mg/dL, SDH <54 mg/dL and PRH (median episodes per week), and their relationship (SDH matched to PRH within 1 h)
- Follow-up
- 10 weeks
Methodological detailsblinded CGM, 10-week app-based recording
- Blinded CGM
- 10-week app-based recording
Main finding
As reported in the abstract
Hypoglycemia rates (median episodes per week)
- Sensor-detected hypoglycemia (SDH) <70 mg/dL: T1D vs T2D, median [IQR]
- 6.5 [3.8-10.4] vs. 2.1 [0.8-4.0]
- SDH <54 mg/dL: T1D vs T2D, median [IQR]
- 1.2 [0.4-2.5] vs. 0.2 [0.0-0.5]
- PRH: T1D vs T2D, median [IQR]
- 3.9 [2.4-5.9] vs. 1.1 [0.5-2.0]
- Overall SDH <70 mg/dL not associated with PRH
- 65%
- Overall PRH with no associated SDH
- 43%
Observational data: associations, not effects.
Further findings
Median proportion of SDH associated with PRH
- SDH <70 mg/dL: T1D vs T2D
- 40% vs. 22%
- SDH <54 mg/dL: T1D vs T2D
- 47% vs. 25%
Original publication
Relationship Between Sensor-Detected Hypoglycemia and Patient-Reported Hypoglycemia in People With Type 1 and Insulin-Treated Type 2 Diabetes: The Hypo-METRICS Study. Diabetes Care. Published 29 August 2024. doi:10.
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