Endocrine Abstracts

Introduction: Hypoglycemia consists a significant problem in insulin treated type 2 diabetic patients. The present study compared the incidence of hypoglycemic episodes in type 2 diabetics between continuous glucose monitoring/CGM vs self monitoring of blood glucose/SMBG.

Methods: Seventeen patients with type 2 diabetes underwent a 24 h CGM for a period of 3–5 consecutive days. At the same period they recorded their glucose values using SMBG from four daily measurements. The main end points were: i) potential differences in detection of hypoglycemic episodes depending on the recording method (CGM vs SMBG) and ii) assessment of the recorded hypoglycemic episodes pattern (nocturnal vs no nocturnal hypoglycemia).

Results: According to CGM, ten type 2 diabetic patients experienced at least one hypoglycemic episode, while four patients experienced at least one hypoglycemic episode as illustrated by SMBG (58.8% vs 23.5%, P=0.07). i) 23 hypoglycemic episodes were recorded by CGM vs eight episodes which were recorded using SMBG (mean 1.35 vs 0.48, P=0.008) ii) four patients (23.5% of type 2 diabetic subjects) were detected by CGM suffering from nocturnal hypoglycemia. In contrast, no nocturnal hypoglycemic episodes detected and none recorded by SMBG, since no patient performed glucose measurements during the night. In addition to, six patients recorded hypoglycemia while they were alert, four of whom (23.5%) were asymptomatic.

Conclusions: In type 2 diabetic patients more hypoglycemic episodes are detected using CGM than SMBG (24 vs 8, P=0.008). Furthermore, 23.5% of type 2 diabetics experience nocturnal hypoglycemia and an equal percentage experience unawareness of hypoglycemia undetected by SMBG. In conclusion, CGM seems to be a useful tool for the detection and assessment of hypoglycemia in type 2 diabetic patients.