Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2017

Within-day variability based on 9-point profiles correlates with risk of overall and nocturnal hypoglycaemia in adults with type 1 (T1D) and type 2 diabetes (T2D) (#32)

Timothy Bailey 1 , Anuj Bhargava 2 , J. Hans De Vries 3 , Gregg Gerety 4 , Janusz Gumprecht 5 , Wendy Lane 6 , Carol H Wysham 7 , Britta Anker Bak 8 , Charlotte Thim Hansen 8 , Athena Philis-Tsimikas 9 , Roger Chen 10
  1. AMCR Institute, Escondido, California, USA
  2. Iowa Diabetes and Endocrinology Research Center, Des Moines, Iowa, USA
  3. Department of Endocrinology, University of Amsterdam, Amsterdam, The Netherlands
  4. Albany Medical Center, Albany, New York, USA
  5. Medical University of Silesia, Zabrze, Poland
  6. Mountain Diabetes and Endocrine Center, Asheville, North Carolina, USA
  7. Rockwood Clinic, Spokane, Washington, USA
  8. Novo Nordisk A/S, Søborg, Please Select, Denmark
  9. Whittier Diabetes Institute, Scripps Health, San Diego, California, USA
  10. Concord Repatriation General Hospital, Concord, NSW, Australia

Higher glycaemic variability has previously been linked to an increased risk of hypoglycaemia.

The correlation between within-day variability, based on 9-point profiles, and hypoglycaemia was investigated in two double-blind, treat-to-target, crossover trials comparing insulin degludec once daily (OD) with insulin glargine 100 units/mL OD in adults with T1D (SWITCH 1, n=501) or insulin-experienced adults with T2D (SWITCH 2, n=721). Within-day glycaemic variability was calculated as the relative fluctuation of the 9-point profile, defined through the integrated absolute distance from the mean within-day variability. Variabilities were subsequently categorised into low, medium and high tertiles based on the geometric mean. Hypoglycaemia was defined as overall symptomatic (severe or blood glucose [<3.2 mmol/L] confirmed), nocturnal symptomatic (00:01–05:59) and severe (requiring third-party assistance and confirmed by a blinded adjudication committee) events.

This analysis showed that an increase in within-day variability has a significant correlation with an increasing risk of overall and nocturnal hypoglycaemia (Table). However, no correlation was found for severe hypoglycaemia in this dataset.

In conclusion, within-day glycaemic variability is associated with a risk of overall and nocturnal hypoglycaemia.

 

Table. Effect of within-day variability (9-point profile) on hypoglycaemia in SWITCH 1 and 2: low and high tertiles compared with medium tertile.

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