Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany.
Institute for General Physiology, Ulm University, Ulm, Germany.
J Diabetes Sci Technol. 2024 Sep;18(5):1035-1043. doi: 10.1177/19322968241267765. Epub 2024 Aug 19.
Nocturnal hypoglycaemia is a burden for people with diabetes, particularly when treated with multiple daily injections (MDI) therapy. However, the characteristics of nocturnal hypoglycaemic events in this patient group are only poorly described in the literature.
Continuous glucose monitoring (CGM) data from 185 study participants with type 1 diabetes using MDI therapy were collected under everyday conditions for up to 13 weeks. Hypoglycaemic events were identified as episodes of consecutive CGM readings <70 mg/dl or <54 mg/dl for at least 15 minutes. Subsequently, the time <54 mg/dl (TB54), time below range (TBR), time in range (TIR), time above range (TAR), glucose coefficient of variation (CV), and incidence of hypoglycaemic events were calculated for diurnal and nocturnal periods. Furthermore, the effect of nocturnal hypoglycaemic events on glucose levels the following day was assessed.
The incidence of hypoglycaemic events <70 mg/dl was significantly lower during the night compared to the day, with 0.8 and 3.8 events per week, respectively, while the TBR, TB54, and incidence of events with CGM readings <54 mg/dl was not significantly different. Nocturnal hypoglycaemic events <70 mg/dl were significantly longer (60 vs 35 minutes) and enveloped by less rapidly changing glucose levels. On days following nights containing hypoglycaemic events, there was a decrease in TAR, mean CGM glucose level and morning glucose levels and an increase in TB54, TBR, and CV.
The results showed that nocturnal hypoglycaemic events are a common occurrence in persons with type 1 diabetes using MDI with significant differences between the characteristics of nocturnal and diurnal events.
夜间低血糖是糖尿病患者的负担，尤其是在接受多次每日注射（MDI）治疗时。然而，文献中对该患者群体夜间低血糖事件的特征描述甚少。
在 185 名使用 MDI 治疗的 1 型糖尿病患者中，在日常条件下收集了长达 13 周的连续血糖监测（CGM）数据。低血糖事件被定义为连续 CGM 读数<70mg/dl 或<54mg/dl 至少 15 分钟的发作。随后，计算了夜间和白天的 TBR、TB54、TIR、TAR、血糖变异系数（CV）和低血糖事件发生率。此外，还评估了夜间低血糖事件对次日血糖水平的影响。
夜间低血糖事件发生率<70mg/dl 明显低于白天，分别为每周 0.8 和 3.8 次，而 TBR、TB54 和 CGM 读数<54mg/dl 的事件发生率则无明显差异。夜间低血糖事件<70mg/dl 的持续时间明显更长（60 分钟 vs 35 分钟），且血糖水平变化较慢。在夜间发生低血糖事件后的日子里，TAR、平均 CGM 血糖水平和早晨血糖水平下降，TB54、TBR 和 CV 增加。
结果表明，夜间低血糖事件在使用 MDI 的 1 型糖尿病患者中很常见，夜间和日间事件的特征存在显著差异。
