Frequency of Rebound Hyperglycemia in Adults with Type 1 Diabetes Treated with Different Insulin Delivery Modalities
Open accessAbstract
Background: For people with type 1 diabetes (T1D), ensuring fast and effective recovery from hypoglycemia while avoiding posthypoglycemic hyperglycemia (rebound hyperglycemia, RH) can be challenging. The objective of this study was to investigate the frequency of RH across different treatment modalities and its impact on glycemic control. Methods: This cross-sectional real-world study included adults with T1D using continuous glucose monitoring and attending the outpatient clinic at Steno Diabetes Center Copenhagen. RH was defined as ≥1 sensor glucose value (SG) >10.0 mmol/L (180 mg/dL) starting within 2 h of an antecedent SG <3.9 mmol/L (70 mg/dL). The severity of the RH events was calculated as area under the curve (AUC) and separately for users of multiple daily injections (MDIs), unintegrated insulin pumps, sensor augmented pumps (SAPs), and automated insulin delivery (AID), respectively. Results: Across the four groups, SAP and AID users had the highest incidence of RH (2.06 ± 1.65 and 2.08 ± 1.49 events per week, respectively) and a similar percentage of hypoglycemic events leading to RH events (41.3 ± 22.8% and 39.6 ± 20.1%, respectively). The AID users with RH events were significantly shorter compared with MDI users (122 ± 72 vs. 185 ± 135 min; P < 0.0001). Overall, severity of RH was inversely associated with more advanced technology ( P < 0.001) and inversely associated ( P < 0.001) with time in target range (TIR). Conclusions: Groups with insulin suspension features experienced the highest frequency of RH; however, AID users tended to experience shorter and less severe RH events. The association between the severity of RH events and TIR suggests that RH should be assessed and used in the guidance of hypoglycemia management.
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Most time-in-range recommendations allow up to 10 mmol/L as the upper threshold.
“This was a rather strict definition for rebound hyperglycemia, because most time-in-range recommendations allow up to 10 mmol/L as the upper threshold [14–16].”
From Systematic review of oral carbohydrate treatment for hypoglycemia in people living with type 2 diabetes mellitus (2026) · cites this paper as [15]
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Beck, R. W., Riddlesworth, T., Ruedy, K., Ahmann, A., Bergenstal, R., Haller, S., Kollman, C., Kruger, D., McGill, J. B., Polonsky, W., et al. (2017) · JAMA · doi:10.1001/jama.2016.19975 · Cited by 1,185 · see citing works
The barrier of hypoglycemia in diabetes
Cryer, P. E. (2008) · Diabetes · doi:10.2337/db08-1084 · Cited by 725 · see citing works
Heinemann, L., Freckmann, G., Ehrmann, D., Faber-Heinemann, G., Guerra, S., Waldenmaier, D., & Hermanns, N. (2018) · The Lancet · doi:10.1016/s0140-6736(18)30297-6 · Cited by 522 · see citing works
1. Improving Care and Promoting Health in Populations: Standards of Care in Diabetes—2024
ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Hilliard, M. E., Johnson, E. L., Khunti, K., Lingvay, I., et al. (2023) · Diabetes Care · doi:10.2337/dc24-s001 · Cited by 216 · see citing works
Visser, M. M., Charleer, S., Fieuws, S., De Block, C., Hilbrands, R., Van Huffel, L., Maes, T., Vanhaverbeke, G., Dirinck, E., Myngheer, N., et al. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00789-3 · Cited by 165 · see citing works
Ólafsdóttir, A. F., Polonsky, W. H., Bolinder, J., Hirsch, I. B., Dahlqvist, S., Wedel, H., Nyström, T., Wijkman, M. O., Schwarcz, E., Hellman, J., et al. (2018) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2017.0363 · Cited by 115 · see citing works
Food cravings during acute hypoglycaemia in adults with type 1 diabetes
Strachan, M. W. J., Ewing, F. M. E., Frier, B. M., Harper, A., & Deary, I. J. (2004) · Physiology & Behavior · doi:10.1016/j.physbeh.2003.12.003 · Cited by 55 · see citing works
Acciaroli, G., Welsh, J. B., & Akturk, H. K. (2022) · Journal of Diabetes Science and Technology · doi:10.1177/1932296820982584 · Cited by 27 · see citing works
Nørgaard, K., Ranjan, A. G., Laugesen, C., Tidemand, K. G., Green, A., Selmer, C., Svensson, J., Andersen, H. U., Vistisen, D., & Carstensen, B. (2023) · Diabetes Care · doi:10.2337/dc23-1137 · Cited by 26 · see citing works
Self-citationHermanns, N., Ehrmann, D., Heinemann, L., Freckmann, G., Waldenmaier, D., & Calhoun, P. M. (2022) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2022.0130 · Cited by 18 · see citing works
Rebound Hypoglycemia and Hyperglycemia in Type 1 Diabetes
Hansen, K. W., & Bibby, B. M. (2024) · Journal of Diabetes Science and Technology · doi:10.1177/19322968231168379 · Cited by 17 · see citing works
Colinet, V., & Lysy, P. A. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.887976 · Cited by 7 · see citing works
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Prince, N., Lochnan, H., Shorr, R., Garon-Mailer, A., & Sun, C. J. (2026) · BMC Endocrine Disorders · doi:10.1186/s12902-025-02144-3
- Authors
- Tidemand, K. G., Laugesen, C., Ranjan, A. G., Skovhus, L. B., & Nørgaard, K.
- Affiliations
- Copenhagen University Hospital (DK)
- University of Copenhagen (DK)
- Venue
- Diabetes Technology & Therapeutics
- Publisher
- SAGE Publications
- Published
- 2025-01
- Volume
- 27
- Issue
- 1
- Pages
- 60-65
- ISSN
- 1520-9156 (ISSN-L)
- 1557-8593
- OpenAlex
- W4400977738
- Cited by
- 9
- References
- 12
- Citations by year
- 2026: 4 · 2025: 5
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Technology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Steno Diabetes Center Copenhagen (SDCC 3.E Technology)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- rebound hyperglycemia, type 1 diabetes, hypoglycemia, artificial pancreas, sensor-augmented pump, insulin pump, multiple daily insulin injections, continuous glucose monitoring, time in range, glycemic control, hypoglycemia management
- MeSH terms
- Glycemic Control, Adult, Blood Glucose, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Female, Humans, Hyperglycemia, Hypoglycemia, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Male, Middle Aged, Blood Glucose Self-Monitoring
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