Prevention and Management of Severe Hypoglycemia and Hypoglycemia Unawareness: Incorporating Sensor Technology

• Published in: Current diabetes reports 2018-10, Vol.18 (10), p.83-10, Article 83
• Main Authors: Lucidi, Paola, Porcellati, Francesca, Bolli, Geremia B., Fanelli, Carmine G.
• Format: Article
• Language: English
• Subjects: Blood Glucose - metabolism; Blood Glucose Self-Monitoring; Diabetes; Glucose; Glucose monitoring; Health Knowledge, Attitudes, Practice; Humans; Hypoglycemia; Hypoglycemia - blood; Hypoglycemia - drug therapy; Hypoglycemia - physiopathology; Hypoglycemia - prevention & control; Insulin; Insulin - therapeutic use; Medicine; Medicine & Public Health; Monitoring, Physiologic - instrumentation; Section Editor; Sensors; Therapies and New Technologies in the Treatment of Diabetes (M Pietropaolo; Topical Collection on Therapies and New Technologies in the Treatment of Diabetes
• ISSN: 1534-4827; 1539-0829
• DOI: 10.1007/s11892-018-1065-6

Purpose of Review In addition to assisting in achieving improved glucose control, continuous glucose monitoring (CGM) sensor technology may also aid in detection and prevention of hypoglycemia. In this paper, we report on the current scientific evidence on the effectiveness of this technology in the prevention of severe hypoglycemia and hypoglycemia unawareness. Recent Findings Recent studies have found that the integration of CGM with continuous subcutaneous insulin infusion (CSII) therapy, a system known as sensor-augmented pump (SAP) therapy, very significantly reduces the occurrence of these conditions by providing real-time glucose readings/trends and automatically suspending insulin infusion when glucose is low (LGS) or, even, before glucose is low but is predicted to soon be low (PLGS). Initial data indicate that even for patients with type 1 diabetes treated with multiple daily injections, real-time CGM alone has been found to reduce both severe hypoglycemia and hypoglycemia unawareness. Closed loop systems (artificial pancreas) comprised of CGM and CSII without patient intervention to adjust basal insulin, which automatically reduce, increase, and suspend insulin delivery, represent a potential new option that is moving toward becoming a reality in the near future. Summary Sensor technology promises to continue to improve patients’ lives not only by attaining glycemic control but also by reducing hypoglycemia, a goal best achieved in conjunction with structured individualized patient education.