Glycemic Variability Associated with Time Spent in Hypoglycemia in Type 1 Diabetes—Explorative Data in Real-World, Real-Time Continuous Glucose Monitoring

Abstract

Glycemic variability has previously been associated with risk of hypoglycemia. Cornerstone4Care (C4C), a digital patient management program for diabetes mellitus, supports diabetes self-managing and captures patient data inclusive real-world real-time continuous glucose monitoring (CGM) data. The objective was to explore the association between glucose variability and time spent in hypoglycemia (TIH; percent time with interstitial glucose (IG) <54 mg/dL [3.0mmol/L]) and the association between mean IG and TIH in real-world CGM data. Glucose variability was determined based on CGM data from 112 type 1 diabetes (T1D) patients uploaded via the C4C app and calculated as the coefficient of variation (CV) based on the last 14 days’ available CGM data. For each patient a CV-index, mean IG, and proportion of TIH was determined. The variability CV-index ranged from 11% to 56%. Increase in CV appeared to increase TIH. Mean IG did not seem to influence the time spent in hypoglycemia as much. In addition, when CV exceeded the newly recommended cut-off of 36%, the TIH seemed to increase. In conclusion, higher glucose variability (CV) based on CGM data from T1D was observed to increase the time spent in hypoglycemia. The increase seemed to occur with a CV around 30-36% and seemed to be more independent of mean IG. Data source: https://www.cornerstones4care.com/. Disclosure E. Hachmann-Nielsen: Employee; Self; Novo Nordisk A/S. T. Bartholdy: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. C. Djurhuus: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. K. Kvist: Employee; Self; Novo Nordisk A/S.