Are nocturnal hypoglycemia prevention strategies influenced by diabetes technology usage? A BETTER registry analysis. (September 2022)

• Record Type: Journal Article
• Authors: Talbo, Meryem K.; Rabasa-Lhoret, Rémi; Yale, Jean-François; Peters, Tricia M.; Brazeau, Anne-Sophie
• Is Part Of: Diabetes research and clinical practice. Volume 191(2022)
• Publication Date: 2022-09
• Subjects: Type 1 diabetes -- Continuous glucose monitoring -- Nocturnal hypoglycemia -- Prevention strategies -- Insulin pump; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2022.110080
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aim: To assess the association of nocturnal hypoglycemia prevention strategies (NH-PS) and diabetes technology usage (insulin pump and/or continuous glucose monitors [CGM]) in people with type 1 diabetes (PWT1D). Methods: Logistic regression models were used to describe associations between self-reported NH-PS and diabetes technology (pump with intermittently-scanned or real-time CGM (isCGM or rtCGM), or automated insulin delivery (AID)), hypoglycemia history, and fear of hypoglycemia (FOH). Results: Among 831 adults (65 % female, aged 44 ± 15 years, T1D duration 26 ± 15 years), 32 % reported HbA1c ≤ 7.0 %, 88 % used ≥ 1 diabetes technology, 66 % reported ≥ 1 symptomatic NH in the past month, and 64 % used ≥ 2 NH-PS. Compared to multiple daily injections (MDI) + capillary blood glucose (CBG), bedtime snack consumption was less likely among pump + isCGM (OR [95 %CI]: 0.55 [0.31, 0.98]), pump + rtCGM (0.40 [0.20, 0.81]), and AID (0.34 [0.17, 0.66]) users, while evening insulin basal reduction was associated with CSII + CBG (3.15 [1.25, 7.99]), pump + isCGM 4.00 [1.99, 8.01]), and pump + rtCGM 2.89 [1.28, 6.50] use. Elevated FOH was associated with snack consumption (1.37 [1.00, 1.89]), evening bolus insulin avoidance (1.77 [1.11, 2.83]), limiting exercise (2.50 [1.30, 4.82]), and limiting alcohol consumption (2.33 [1.15, 4.70]) as NH-PS. Conclusion: Technology use and elevated FOH might influence PWT1D' choice of NH-PS.