Clinically Serious Hypoglycemia Is Rare and Not Associated With Time-in-range in Youth With New-onset Type 1 Diabetes

• Published in: The journal of clinical endocrinology and metabolism 2021-11, Vol.106 (11), p.3239-3247
• Main Authors: Addala, Ananta, Zaharieva, Dessi P, Gu, Angela J, Prahalad, Priya, Scheinker, David, Buckingham, Bruce, Hood, Korey K, Maahs, David M
• Format: Article
• Language: English
• Subjects: Adolescent; Analysis; Biomarkers - blood; Blood Glucose - analysis; Blood Glucose Self-Monitoring; Blood sugar monitoring; Child; Clinical; Dextrose; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - metabolism; Diabetes Mellitus, Type 1 - physiopathology; Female; Follow-Up Studies; Glucose; Glycated Hemoglobin A - analysis; Glycosylated hemoglobin; Humans; Hypoglycemia - chemically induced; Hypoglycemia - epidemiology; Hypoglycemia - metabolism; Hypoglycemia - pathology; Hypoglycemic Agents - therapeutic use; Male; Prognosis; Retrospective Studies; Teenagers; Type 1 diabetes; United States - epidemiology; Youth
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/clinem/dgab522

Early initiation of continuous glucose monitoring (CGM) is advocated for youth with type 1 diabetes (T1D). Data to guide CGM use on time-in-range (TIR), hypoglycemia, and the role of partial clinical remission (PCR) are limited. Our aims were to assess whether 1) an association between increased TIR and hypoglycemia exists, and 2) how time in hypoglycemia varies by PCR status. We analyzed 80 youth who were started on CGM shortly after T1D diagnosis and were followed for up to 1-year post diagnosis. TIR and hypoglycemia rates were determined by CGM data and retrospectively analyzed. PCR was defined as (visit glycated hemoglobin A1c) + (4*units/kg/day) less than 9. Youth were started on CGM 8.0 (interquartile range, 6.0-13.0) days post diagnosis. Time spent at less than 70 mg/dL remained low despite changes in TIR (highest TIR 74.6 ± 16.7%, 2.4 ± 2.4% hypoglycemia at 1 month post diagnosis; lowest TIR 61.3 ± 20.3%, 2.1 ± 2.7% hypoglycemia at 12 months post diagnosis). No events of severe hypoglycemia occurred. Hypoglycemia was rare and there was minimal difference for PCR vs non-PCR youth (54-70 mg/dL: 1.8% vs 1.2%, P = .04;