A Comparison of the Rates of Clock-Based Nocturnal Hypoglycemia and Hypoglycemia While Asleep Among People Living with Diabetes: Findings from the Hypo-METRICS Study
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A Comparison of the Rates of Clock-Based Nocturnal Hypoglycemia and Hypoglycemia While Asleep Among People Living with Diabetes : Findings from the Hypo-METRICS Study. / Martine-Edith, Gilberte; Divilly, Patrick; Zaremba, Natalie; Søholm, Uffe; Broadley, Melanie; Baumann, Petra Martina; Mahmoudi, Zeinab; Gomes, Mikel; Ali, Namam; Abbink, Evertine J.; de Galan, Bastiaan; Brøsen, Julie; Pedersen-Bjergaard, Ulrik; Vaag, Allan A.; McCrimmon, Rory J.; Renard, Eric; Heller, Simon; Evans, Mark; Cigler, Monika; Mader, Julia K.; Speight, Jane; Pouwer, Frans; Amiel, Stephanie A.; Choudhary, Pratik.
I: Diabetes Technology and Therapeutics, 2024.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - A Comparison of the Rates of Clock-Based Nocturnal Hypoglycemia and Hypoglycemia While Asleep Among People Living with Diabetes
T2 - Findings from the Hypo-METRICS Study
AU - Martine-Edith, Gilberte
AU - Divilly, Patrick
AU - Zaremba, Natalie
AU - Søholm, Uffe
AU - Broadley, Melanie
AU - Baumann, Petra Martina
AU - Mahmoudi, Zeinab
AU - Gomes, Mikel
AU - Ali, Namam
AU - Abbink, Evertine J.
AU - de Galan, Bastiaan
AU - Brøsen, Julie
AU - Pedersen-Bjergaard, Ulrik
AU - Vaag, Allan A.
AU - McCrimmon, Rory J.
AU - Renard, Eric
AU - Heller, Simon
AU - Evans, Mark
AU - Cigler, Monika
AU - Mader, Julia K.
AU - Speight, Jane
AU - Pouwer, Frans
AU - Amiel, Stephanie A.
AU - Choudhary, Pratik
N1 - Publisher Copyright: Copyright 2024, Mary Ann Liebert, Inc., publishers.
PY - 2024
Y1 - 2024
N2 - Introduction: Nocturnal hypoglycemia is generally calculated between 00:00 and 06:00. However, those hours may not accurately reflect sleeping patterns and it is unknown whether this leads to bias. We therefore compared hypoglycemia rates while asleep with those of clock-based nocturnal hypoglycemia in adults with type 1 diabetes (T1D) or insulin-treated type 2 diabetes (T2D). Methods: Participants from the Hypo-METRICS study wore a blinded continuous glucose monitor and a Fitbit Charge 4 activity monitor for 10 weeks. They recorded details of episodes of hypoglycemia using a smartphone app. Sensor-detected hypoglycemia (SDH) and person-reported hypoglycemia (PRH) were categorized as nocturnal (00:00-06:00 h) versus diurnal and while asleep versus awake defined by Fitbit sleeping intervals. Paired-sample Wilcoxon tests were used to examine the differences in hypoglycemia rates. Results: A total of 574 participants [47% T1D, 45% women, 89% white, median (interquartile range) age 56 (45-66) years, and hemoglobin A1c 7.3% (6.8-8.0)] were included. Median sleep duration was 6.1 h (5.2-6.8), bedtime and waking time ∼23:30 and 07:30, respectively. There were higher median weekly rates of SDH and PRH while asleep than clock-based nocturnal SDH and PRH among people with T1D, especially for SDH <70 mg/dL (1.7 vs. 1.4, P < 0.001). Higher weekly rates of SDH while asleep than nocturnal SDH were found among people with T2D, especially for SDH <70 mg/dL (0.8 vs. 0.7, P < 0.001). Conclusion: Using 00:00 to 06:00 as a proxy for sleeping hours may underestimate hypoglycemia while asleep. Future hypoglycemia research should consider the use of sleep trackers to record sleep and reflect hypoglycemia while asleep more accurately. The trial registration number is NCT04304963.
AB - Introduction: Nocturnal hypoglycemia is generally calculated between 00:00 and 06:00. However, those hours may not accurately reflect sleeping patterns and it is unknown whether this leads to bias. We therefore compared hypoglycemia rates while asleep with those of clock-based nocturnal hypoglycemia in adults with type 1 diabetes (T1D) or insulin-treated type 2 diabetes (T2D). Methods: Participants from the Hypo-METRICS study wore a blinded continuous glucose monitor and a Fitbit Charge 4 activity monitor for 10 weeks. They recorded details of episodes of hypoglycemia using a smartphone app. Sensor-detected hypoglycemia (SDH) and person-reported hypoglycemia (PRH) were categorized as nocturnal (00:00-06:00 h) versus diurnal and while asleep versus awake defined by Fitbit sleeping intervals. Paired-sample Wilcoxon tests were used to examine the differences in hypoglycemia rates. Results: A total of 574 participants [47% T1D, 45% women, 89% white, median (interquartile range) age 56 (45-66) years, and hemoglobin A1c 7.3% (6.8-8.0)] were included. Median sleep duration was 6.1 h (5.2-6.8), bedtime and waking time ∼23:30 and 07:30, respectively. There were higher median weekly rates of SDH and PRH while asleep than clock-based nocturnal SDH and PRH among people with T1D, especially for SDH <70 mg/dL (1.7 vs. 1.4, P < 0.001). Higher weekly rates of SDH while asleep than nocturnal SDH were found among people with T2D, especially for SDH <70 mg/dL (0.8 vs. 0.7, P < 0.001). Conclusion: Using 00:00 to 06:00 as a proxy for sleeping hours may underestimate hypoglycemia while asleep. Future hypoglycemia research should consider the use of sleep trackers to record sleep and reflect hypoglycemia while asleep more accurately. The trial registration number is NCT04304963.
KW - Continuous glucose monitoring
KW - Fitbit
KW - Hypo-METRICS
KW - Nocturnal hypoglycemia
KW - Sleep tracking
U2 - 10.1089/dia.2023.0522
DO - 10.1089/dia.2023.0522
M3 - Journal article
C2 - 38386436
AN - SCOPUS:85191374013
JO - Diabetes Technology & Therapeutics
JF - Diabetes Technology & Therapeutics
SN - 1520-9156
ER -
ID: 393138683