688-P: Comparing Rates of Sensor-Detected Hypoglycaemia and Patient-Reported Hypoglycaemia by Method of Glucose Monitoring: The Hypo-METRICS Trial

Abstract

Continuous glucose monitoring (CGM) allows greater detection of hypoglycemia. We compared rates and duration of sensor detected hypoglycemia (SDH) and patient reported hypoglycemia (PRH) in people with type 1 diabetes (T1D) and normal awareness of hypoglycemia (NAH) (Gold score >4) using either flash or capillary blood glucose (CGB) monitoring. We included 91 participants (70 CGM vs. 21 CBG) with T1D with >1 hypoglycemic episode in the last month. They used blinded CGM in addition to their usual glucose monitoring and recorded PRH (symptomatic event that resolved on carbohydrate ingestion, or a self-measured glucose <72 mg/dl) in real time on a smartphone app for weeks. Sleep status was obtained using wrist wore actigraphy. Median (IQR) time in range (TIR) , 59.4 (17.4) vs 60.1 (16.9) % p=.54 and time below range, 4.6 (5.3) vs. 3.6 (5.7) % p=0.39, were not different. There were no significant differences in rates or duration of SDH <70 mg/dl or <54 mg/dl (table 1) . Rates of PRH were higher in the CGM group while awake, 2.9 (2.6) vs. 1.9 (2.6) episodes/week p=.039, with no difference during sleep. Median duration of SDH < 40mg/dl while awake was longer, 20.1 (12.7) vs. 43.2 (7.0) minutes p=.0068. For a given TIR, people with T1DM have similar hypoglycemia exposure regardless of mode of monitoring. CGM enhances awareness of events and shortens events < 40mg/dl whilst awake. Disclosure P.Divilly: None. S.R.Heller: Advisory Panel; Eli Lilly and Company, Medtronic, Mylan N.V., Zealand Pharma A/S, Zucara Therapeutics, Other Relationship; Eli Lilly and Company, Research Support; Dexcom, Inc., Speaker’s Bureau; Novo Nordisk A/S. M.Evans: Advisory Panel; Pila Pharma, Zucara Therapeutics, Other Relationship; Abbott Diabetes, Dexcom, Inc., Medtronic, Novo Nordisk, Research Support; AstraZeneca, Sanofi, Speaker’s Bureau; Lilly Diabetes. S.A.Amiel: Advisory Panel; Medtronic, Novo Nordisk, Other Relationship; Sanofi. P.Choudhary: Advisory Panel; Abbott Diabetes, Lilly Diabetes, Medtronic, Research Support; Novo Nordisk, Speaker’s Bureau; Dexcom, Inc., Glooko, Inc., Insulet Corporation, Sanofi. A.Seibold: Employee; Abbott Diabetes, Stock/Shareholder; Abbott. G.Martine-edith: Other Relationship; Novo Nordisk. Z.Mahmoudi: Employee; Novo Nordisk A/S. N.Zaremba: None. U.Soeholm: Research Support; Novo Nordisk A/S. B.E.De galan: Research Support; Novo Nordisk. U.Pedersen-bjergaard: Advisory Panel; Novo Nordisk A/S, Sanofi. R.J.Mccrimmon: Advisory Panel; Novo Nordisk, Sanofi, Research Support; Diabetes UK, European Union, MedImmune. E.Renard: Consultant; Abbott, AstraZeneca, Boehringer Ingelheim International GmbH, Dexcom, Inc., Insulet Corporation, LifeScan, Lilly, Novo Nordisk, Roche Diabetes Care, Sanofi, Tandem Diabetes Care, Inc. Funding Innovative Medicines Initiative (777460)