An Innovative Approach for Predicting Severe Hypoglycemia

Abstract

Cox DJ, Gonder-Frederick L, Ritterband L, Clarke W, Kovatachev BP: Prediction of severe hypoglycemia. Diabetes Care 30:1370–1373, 2007 Objective. Research demonstrates the importance of achieving near-normal glycemia in the prevention of diabetes-related complications.1 However, in an effort to attain euglycemia, one runs the risk for hypoglycemia.2 Severe hypoglycemia (SH), a low blood glucose resulting in stupor, seizure, or unconsciousness, prohibits self-treatment. To prevent SH, one must be able to anticipate when an event may occur to initiate treatment steps or identify warning signs and take action to stop further progression. The objective of this study was to test methods for predicting SH by using blood glucose meter readings. Design and methods. One hundred adults with type 1 diabetes and 79 insulin-using adults with type 2 diabetes participated in this study. Their self-monitoring of blood glucose (SMBG) readings were stored on memory meters, and the patients were asked biweekly about the occurrence of SH. Results. Relative risk (RR) for SH, quantified by the ratio of an individual's low blood glucose index (LBGI) based on the previous 150 SMBG readings to the LBGI based on recent SMBG readings, increased significantly in the 24-hour period before SH episodes in individuals with either type 1 or type 2 diabetes. An algorithm detected 58% of impending SH episodes when three SMBG readings …