Prolonged Nocturnal Hypoglycemia Is Common During 12 Months of Continuous Glucose Monitoring in Children and Adults With Type 1 Diabetes
Open accessAbstract
OBJECTIVE: To characterize the amount of nocturnal hypoglycemia and evaluate factors associated with nocturnal hypoglycemia assessed with continuous glucose monitoring (CGM) in adults and children with type 1 diabetes who participated in the Juvenile Diabetes Research Foundation CGM randomized clinical trial. RESEARCH DESIGN AND METHODS: The analysis included 36,467 nights with ≥4 h of CGM glucose readings between 12 midnight and 6:00 a.m. from 176 subjects assigned to the CGM group of the trial. The percentage of nights in which hypoglycemia occurred (two consecutive CGM readings ≤60 mg/dl in 20 min) was computed for each subject. Associations with baseline characteristics and clinical factors were evaluated using a multivariate regression model. RESULTS: Hypoglycemic events occurred during 8.5% of nights, with the median percentage of nights with hypoglycemia per subject being 7.4% (interquartile range 3.7–12.1%). The duration of hypoglycemia was ≥2 h on 23% of nights with hypoglycemia. In a multivariate model, a higher incidence of nocturnal hypoglycemia was associated with 1) lower baseline A1C levels (P < 0.001) and 2) the occurrence of hypoglycemia on one or more nights during baseline blinded CGM (P < 0.001). The hypoglycemia frequency was not associated with age or with insulin modality (pump versus multiple daily injections). CONCLUSIONS: Nocturnal hypoglycemia is frequent and often prolonged in adults and children with type 1 diabetes. Patients with low A1C levels are at an increased risk for its occurrence. One week of blinded CGM can identify patients who are at greater risk for nocturnal hypoglycemia.
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In a second study, continuous glucose monitoring lowered nocturnal hypoglycaemia in children (<18 years) with type 1 diabetes, compared with self-monitored blood glucose.
“In a second study, continuous glucose monitoring lowered nocturnal hypoglycaemia in children (<18 years) with type 1 diabetes, compared with self-monitored blood glucose.92”
From Type 1 diabetes (2014) · cites this paper as [92]
The Research Design and Methods section includes children with type 1 diabetes, but this analysis uses only participants assigned to the CGM group. The Results report nocturnal hypoglycemia during CGM use; they do not compare it with self-monitored blood glucose or show that CGM lowered it in children. No page numbers are available in our copy. (LLM, conf=0.86)
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- Authors
- Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group
- Affiliations
- Juvenile Diabetes Research Foundation (CA)
- Corresponding author
- Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2010-03-03
- Volume
- 33
- Issue
- 5
- Pages
- 1004-1008
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2858162
- OpenAlex
- W2337375610
- Cited by
- 180
- References
- 8
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 5 · 2023: 7 · 2022: 6 · 2021: 8 · 2020: 16 · 2019: 10 · 2018: 11 · 2017: 7 · 2016: 9 · 2015: 12 · 2014: 13 · 2013: 21 · 2012: 17
- FWCI
- 16.22
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (K08DK082386)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- nocturnal hypoglycemia, type 1 diabetes, continuous glucose monitoring, hypoglycemia duration, glycemic control, HbA1c, risk factors, children and adults, insulin pump therapy, multiple daily insulin injections
- MeSH terms
- Adolescent, Adult, Blood Glucose, Child, Circadian Rhythm, Diabetes Mellitus, Type 1, Female, Glycated Hemoglobin, Humans, Hypoglycemia, Hypoglycemic Agents, Injections, Subcutaneous, Insulin, Insulin Infusion Systems, Male, Middle Aged, Risk Factors, Blood Glucose Self-Monitoring, Incidence, Multivariate Analysis, Young Adult
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