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. 2022 May 23;13(4):672-678.
doi: 10.1007/s13340-022-00585-y. eCollection 2022 Oct.

Status of glycemic excursions and hypoglycemia in patients with type 1 diabetes 2 months after first initiation of intermittently scanned continuous glucose monitoring: a pilot study

Yuka Suganuma #  1 , Hiroshi Takahashi #  1 , Rimei Nishimura  1
Affiliations

Status of glycemic excursions and hypoglycemia in patients with type 1 diabetes 2 months after first initiation of intermittently scanned continuous glucose monitoring: a pilot study

Yuka Suganuma et al. Diabetol Int. .

Abstract

Objective: To investigate glycemic excursions and changes in time in hypoglycemia (hyT) in Japanese type 1 diabetes (T1D) patients 2 months after the first initiation of intermittently scanned continuous glucose monitoring (isCGM).

Methods: We enrolled 15 adult T1D patients on insulin therapy to evaluate changes in the parameters for glycemic excursions 2 months after initiating isCGM by using the Wilcoxon signed-rank test. Binomial logistic regression analyses were also used to identify predictors of hypoglycemia.

Results: A total of 14 patients were available for analysis. Median HbA1c decreased significantly from 7.6% (interquartile range, 6.9-8.3%) to 7.2% (6.7-7.8%) (P = 0.047). Mean glucose, standard deviation of glucose, time in range, and time above range were not significantly different from baseline, while time below range (from 2.2 [1.0-6.9] to 5.0 [2.0-10.8]%; P = 0.016), hyT (from 26.8 [14.5-75.5] to 56.8 [21.7-110.9] min/day; P = 0.030), and time in severe hypoglycemia (shT, from 4.3 [0.0-8.9] to 11.0 [0.0-24.3] min/day; P = 0.022) increased significantly. Additionally, shT increased significantly only during daytime. The factor associated with hyT was found to be the reduction in total insulin dose after 2 months.

Conclusions: In T1D patients with a median HbA1c of 7.6%, HbA1c was significantly decreased 2 months after initiating isCGM, while hyT increased, particularly during daytime. Study results suggest that a reduction in the total insulin dose of about 0.10 U/kg may be required in some cases. These findings need to be taken into account when initiating isCGM.

Supplementary information: The online version contains supplementary material available at 10.1007/s13340-022-00585-y.

Keywords: Time below range; Time in hypoglycemia; Time in severe hypoglycemia; Type 1 diabetes; isCGM.

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Conflict of interest statement

Conflict of interestThe authors of this manuscript have the following competing interests: RN received honoraria from Sanofi Co., Ltd., Japan Medtronic Co., Ltd., Nippon Boehringer Ingelheim Co., Ltd., Takeda Pharmaceutical Company Limited, Kissei Pharmaceutical Co., Ltd., Novartis Pharma Co., Ltd., Eli Lilly Japan Co., Ltd., Novo Nordisk Pharma Ltd., MSD and Astellas Pharma Inc, and subsidies or donations from Taisho Pharmaceutical Co., Ltd, Ono Pharmaceutical Co., Ltd, Takeda Pharmaceutical Company Limited and Nippon Boehringer Ingelheim Co., Ltd. TH received honoraria from Eli Lilly Japan Co., Ltd. YS have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Study protocol
Fig. 2
Fig. 2
Change from baseline in TIR, TAR, and TBR 2 months later
See this image and copyright information in PMC

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