Endocrine Abstracts

Insulin clamp studies have shown that women have a lower counterregulatory hormone response to hypoglycaemia. We explored associations between gender and experience of hypoglycaemia among people with type 1 diabetes (T1D) and insulin-treated type 2 diabetes (T2D) in the Hypo-METRICS study. Hypo-METRICS was a 10-week cross-sectional observational study of hypoglycaemia experience. Participants (274 T1D, 321 T2D) wore blinded study continuous glucose monitors (CGMs) and recorded their symptoms of hypoglycaemia on a bespoke Hypo-METRICS app in real-time. Symptomatic hypoglycaemia was defined as symptomatic episodes resolved by carbohydrate ingestion. Chi-squared, Fisher’s and Wilcoxon rank sum tests were used to test for differences between genders. In the T1D group, there was a female predominance (54%), and 76% used CGM. In the T2D group, there was a male predominance (63%), and 40% used CGM. In both T1D and T2D, there were no significant differences in time below range between men and women (all P > 0.05). Women reported more symptomatic hypoglycaemia (4.3 vs 3.3 episodes/week in T1D, 1.4 vs 1 episode/week in T2D; P < 0.05). In T1D, women had higher overall rates of autonomic and neuroglycopenic symptoms, specifically sweating, palpitations, coordination difficulties and headache (all P < 0.05). Men reported higher rates of hunger (P < 0.001). In T2D, women had higher overall rates of neuroglycopenic symptoms, and higher rates of shaking, confusion, difficulty speaking and headache (all P < 0.05). Despite similar exposures to hypoglycaemia, women reported greater hypoglycaemia symptoms in this free-living environment. Further work is needed to elucidate the potential underlying causes of these findings.