SFEBES2015 Poster Presentations Obesity, diabetes, metabolism and cardiovascular (108 abstracts)
Evaluation of hypoglycaemia unawareness in individuals with type 1 diabetes mellitus using continuous glucose monitoring in a tertiary care centre
Dukhabandhu Naik , R M Shilpa , D M Mahesh , H S Asha , Nitin Kapoor , Thomas Paul , V Padmanabhan , Mercy Inbakumari , Flory Christina , Jansi Rani , Divya Natarajan , L Jeyaseelan & Nihal Thomas
Department of Endocrinology, Christian Medical College, Vellore, India.
Background: Intensive glycemic control forms the benchmark of management of type 1 diabetes mellitus (T1DM) and is limited by the risk of hypoglycaemia. Repeated episodes of hypoglycaemia can lead to development of hypoglycaemia unawareness and a sixfold increase in deaths in those experiencing severe hypoglycaemia. Severe hypoglycaemia occurs in 35–42% patients with T1DM. However, there is lack of data from our population and hence we aimed to objectively estimate the prevalence of hypoglycaemia unawareness in subjects with T1DM utilising continuous glucose monitoring (CGM) device.
Methods: The Modified Clarke’s Questionnaire was administered to 124 subjects with T1DM (18–50 years). Of these, 40 subjects (31.7%) with documented severe hypoglycaemia, or hypoglycaemia unawareness underwent a 72 h CGM study using the Medtronic-ipro2 Device (MiniMed, Sylmar, CA, USA). Subjects also self monitored blood glucose with a glucometer (eight times a day: pre and post meal blood glucose, 1200 and 1500 h and whenever symptomatic). Data was obtained using ipro2 Software.
Results: The mean age of the subjects was 25.2 years (18–42) with a 3:2 male:female ratio. CGM documented 144 hypoglycaemic episodes in 32 subjects (25%) with 4.5 episodes/subject and more than 50% of the episodes were nocturnal. In comparison to SMBG which revealed only 83 episodes, CGM identified 42% more hypoglycaemic episodes. The mean duration of diabetes was longer in subjects with hypoglycaemic unawareness (11.7 years vs 7.6 years). The mean HbA1c of subjects with hypoglycaemia unawareness was lower (7.6%) than those without hypoglycaemia unawareness (7.78%) and partial unawareness (8.4%).
Conclusion: Hypoglycaemia unawareness is significant problem in T1DM and CGM forms an essential tool for objective assessment of hypoglycaemia unawareness.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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