Characteristics of presentation and management of people with hypoglycaemia while on continuous glucose monitoring devices - Pilot data from DEKODE hypoglycaemia study.

Abstract

Continuous glucose monitoring (CGM) is an increasingly important diabetes technology that can provide a more comprehensive picture of glycaemic control, thereby having the potential to reduce exposure to hypoglycaemia.1-2 However, there is a paucity of information on admitted patients' characteristics, management, and outcomes of those admitted with hypoglycaemia despite being on CGM. Within our study, we aim to explore the characteristics of the patient population, precipitating factors and outcomes of people admitted with hypoglycaemia while on CGM. Material(s) and This retrospective study was conducted from October 2023 to January 2024 across five hospitals in the UK. All adults aged over 18 years admitted to these hospitals with hypoglycaemia while on CGM from November 2022 to October 2023 were included in the study. Data on sociodemographic, precipitating factors, management, outcomes and total time spent during hypoglycaemic episodes were collected. Data was analysed on SPSS 29.0. Results and discussion: We identified 39 episodes of hypoglycaemia, with 37 occurrences in individuals with type 1 diabetes and 2 in those with type 2 diabetes. 34 episodes occurred while the person was an inpatient in the hospital. The median (interquartile) age was 49.0 (36.0-50.0) years. Their Charlson comorbidity index was 4 (4-6). 79.5% were men. The median (interquartile) HbA1c before admission was 98.0 (60.0-98.0) mmol/mol. 79.5% were level 1, 10.3% were level 2, and 10.3% were level 3 hypoglycaemia. 48.7% of episodes were due to missed meals. Patients spent 26 (16.0-124.0) min in hypoglycaemia during these episodes. 7.7% of people received glucagon either at home, in an ambulance, or in a hospital for hypoglycaemia. However, only 5.1% were prescribed glucagon upon discharge. Conclusion(s): The majority of hypoglycaemia was due to missed meals. Despite spending a median of 26 min in hypoglycaemia, only a small percentage received glucagon, and a mere 5.1% were prescribed glucagon upon discharge. These findings highlight the need for enhanced education and proactive management strategies for individuals on CGM to effectively prevent and address hypoglycaemic episodes, improve diabetes care, and overall patient outcomes. : 1. Continuous Glucose Monitoring. www.diabetes.co.uk/cgm/continuous-glucose-monitoring.html [Accessed 15 February 2024] 2. Pickup J C, Freeman S C, Sutton A J. Glycaemic control in type 1 diabetes during real time continuous glucose monitoring compared with self monitoring of blood glucose: meta-analysis of randomised controlled trials using individual patient data.