Endocrine Abstracts

JOINT2608

Introduction: The recurrence of severe hypoglycemia in diabetic patients poses a significant clinical challenge. Identifying predictive factors for repeated episodes is crucial to improving patient outcomes. Continuous glucose monitoring (CGM) provides detailed insights into glycemic profiles, allowing for the assessment of glucose fluctuations and their potential role in hypoglycemia recurrence. This study evaluates the association between CGM-derived metrics and the likelihood of recurrent severe hypoglycemic episodes in diabetic patients.

Objective: To analyze how variations in glycemic profiles influence the recurrence of severe hypoglycemia in diabetic patients.

Methods: This retrospective observational study included 66 diabetic patients who underwent CGM monitoring. Patients were categorized into two groups based on the presence or absence of recurrent severe hypoglycemia. CGM metrics analyzed included the percentage of time spent in hyperglycemia (>180 mg/dL), hypoglycemia (<70 mg/dL and <54 mg/dL), and the number of hypoglycemic events. The Mann-Whitney U test was used to assess significant differences between groups.

Results: Patients experiencing recurrent severe hypoglycemia demonstrated increased glycemic variability and a lower percentage of time in range. A trend toward an association between higher time spent <54 mg/dL and hypoglycemia recurrence was observed (median 2.8% vs. 1.6%, P = 0.13), although it did not reach statistical significance. Additionally, the group with recurrent episodes had a higher number of total hypoglycemic events (median 21 vs. 15), yet this difference was also not statistically significant (P = 0.47). Other CGM parameters, including time in hyperglycemia and overall glucose variability, suggested an increased risk profile in patients with recurrent hypoglycemia but did not show definitive statistical differences.

Conclusions: Although increased glycemic variability and reduced time in range have been associated with adverse metabolic outcomes, their role in predicting recurrent severe hypoglycemia remains uncertain. The findings of this study suggest a potential trend toward an association between increased time spent <54 mg/dL and hypoglycemia recurrence; however, statistical significance was not achieved, likely due to sample size limitations. Larger prospective studies are needed to further investigate these associations and determine their clinical implications. Future research should focus on refining CGM-based predictive models to enhance hypoglycemia risk stratification and improve patient management strategies.