Poster Presentation The Joint Annual Scientific Meetings of the Endocrine Society of Australia and the Society for Reproductive Biology 2017

Within-day variability based on 9-point profiles correlates with risk of overall and nocturnal hypoglycaemia in adults with type 1 and type 2 diabetes (#188)

Timothy S Bailey 1 , Anuj Bhargava 2 , J Hans De Vries 3 , Gregg Gerety 4 , Janusz Gumprecht 5 , Wendy Lane 6 , Carol H Wysham 7 , Britta A Bak 8 , Charlotte T 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. University of Amsterdam, Amsterdam, Netherlands
  4. Albany Medical Center, Albany, NY, USA
  5. Medical University of Silesia, Zabrze, Poland
  6. Mountain Diabetes and Endocrine Center, Asheville, North Carolina, USA
  7. Rockwood Clinic, Spokane, WA, USA
  8. Novo Nordisk A/S, Søborg, Denmark
  9. Whittier Diabetes Institute, Scripps Health, San Diego, California, USA
  10. Concord Repatriation General Hospital, Concord, NSW, Australia

Higher glycaemic variability has been previously 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 U100 OD in adults with type 1 diabetes (SWITCH 1, n=501) or insulin-experienced adults with type 2 diabetes (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 [<3.1 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 had a significant correlation with an increased risk of overall and nocturnal hypoglycaemia (Table). However, no correlation was found for severe hypoglycaemia in this dataset.

In conclusion, within-day glycaemic variability was 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 the medium tertile.