Majority of Sensor Hypoglycemia Is Not Detected by People Living with Diabetes-Hypo-METRICS Study

The multicentre prospective observational Hypo-METRICS study assessed rates of sensor detected hypoglycemia (SDH) and person reported hypoglycemia-PRH (symptoms resolved by carbohydrates or measured glucose <72 mg/dl), in people with type 1 (T1D) and insulin treated type 2 (T2D) diabetes. We report overall rates of hypoglycemia and the proportion and rates of undetected SDH. All 602 participants (277 T1D vs 325 T2D) had ≥1 PRH in the 3 months prior to the study. They wore a blinded continuous glucose monitor and recorded PRH on the Hypo-METRICS smartphone app for 10 weeks. SDH was defined by ATTD consensus. PRH without SDH ± 1 hour was consider undetected. The median (IQR) weekly rate of PRH was 3.4 (1.9-5.3) vs 0.8 (0.3-1.7) episodes/week in T1D vs T2D respectively (p<0.01), SDH <70mg/dl was 6.7 (3.9-10.8) vs 2.1 (0.9-4.3) episodes/week respectively (p<0.01) and SDH <54mg/dl was 1.3 (0.5-2.8) vs 0.3 (0-0.6) episodes/weeks respectively (p<0.01). The proportion of undetected episodes at SDH <70mg/dl was higher in T2D, 68 vs 78% (p<0.01) and at SDH <54mg/dl, 62 vs 82% (p<0.01). The weekly rates of undetected episodes were higher in T1D for SDH <70mg/dl (4.6 vs 1.8 episodes/week, p<0.01) and for SDH <54mg/dl (0.8 vs 0.2 episodes /week, p<0.01). Baseline characteristics are in table 1. Most sensor hypoglycemia goes undetected by people with diabetes. Further work will assess the impact of undetected episodes. Disclosure P.Divilly: None. S.R.Heller: Advisory Panel; Zealand Pharma A/S, Zucara Therapeutics, Other Relationship; Eli Lilly and Company, Research Support; Dexcom, Inc., Speaker's Bureau; Novo Nordisk, Medtronic. M.Evans: Advisory Panel; Zucara Therapeutics, Pila Pharma, Dexcom, Inc., Other Relationship; Novo Nordisk, AstraZeneca, Abbott Diabetes, Speaker's Bureau; Eli Lilly and Company. J.K.Mader: Advisory Panel; Novo Nordisk A/S, Abbott Diabetes, Roche Diabetes Care, Eli Lilly and Company, Sanofi, Medtronic, Becton, Dickinson and Company, Pharmasense, embecta, Research Support; A. Menarini Diagnostics, Abbott Diabetes, Roche Diabetes Care, Dexcom, Inc., Profusa, Inc., Speaker's Bureau; Novo Nordisk A/S, A. Menarini Diagnostics, Abbott Diabetes, Roche Diabetes Care, Eli Lilly and Company, Sanofi, Boehringer Ingelheim Inc., Becton, Dickinson and Company, Ypsomed AG, Viatris Inc., Servier Laboratories, Medtrust, Stock/Shareholder; Decide Clinical Software GmbH. S.A.Amiel: Advisory Panel; Medtronic, Other Relationship; Sanofi, Novo Nordisk. P.Choudhary: Advisory Panel; Medtronic, Novo Nordisk, Dexcom, Inc., MannKind Corporation, Insulet Corporation, Research Support; Abbott Diabetes, Speaker's Bureau; Sanofi, Lilly. Hypo-resolve consortium: n/a. G.Martine-edith: Other Relationship; Novo Nordisk A/S. Z.Mahmoudi: Employee; Novo Nordisk. N.Zaremba: None. U.Soeholm: Employee; Novo Nordisk A/S. B.E.De galan: Research Support; Novo Nordisk. U.Pedersen-bjergaard: Advisory Panel; Novo Nordisk A/S, Sanofi, Vertex Pharmaceuticals Incorporated. R.J.Mccrimmon: Advisory Panel; Sanofi, Speaker's Bureau; Novo Nordisk A/S. E.Renard: Consultant; Abbott Diabetes, Dexcom, Inc., AstraZeneca, Boehringer-Ingelheim, Eli Lilly and Company, Insulet Corporation, MannKind Corporation, Novo Nordisk, Sanofi, Roche Diabetes Care. Funding Innovative Medicines Initiative 2 Joint Undertaking (777460)