RT Journal Article
SR Electronic
T1 Insight into hypoglycemia frequency in congenital hyperinsulinism: evaluation of a large UK CGM dataset
JF BMJ Open Diabetes Research & Care
JO BMJ Open Diab Res Care
FD American Diabetes Association
SP e002849
DO 10.1136/bmjdrc-2022-002849
VO 10
IS 3
A1 Chris Worth
A1 Yesica Tropeano
A1 Pon Ramya Gokul
A1 Karen E Cosgrove
A1 Maria Salomon-Estebanez
A1 Senthil Senniappan
A1 Antonia Dastamani
A1 Indraneel Banerjee
YR 2022
UL http://drc.bmj.com/content/10/3/e002849.abstract
AB Introduction Hypoglycemia is often recurrent and severe in patients with congenital hyperinsulinism (CHI). However, there is little information regarding frequency or patterns of episodes to inform clinical management and future trial design.Research design and methods We aimed to describe frequency and patterns of hypoglycemia by varying thresholds through a large continuous glucose monitoring (CGM) dataset. Through the UK CHI centers of excellence, data were analyzed from patients with CHI over a 5-year period. Hypoglycemia thresholds of 3.0 (H3.0), 3.5 (H3.5) and 3.9 (H3.9) mmol/L were used to test threshold change on hypoglycemia frequencies.Results From 63 patients, 3.4 million data points, representing 32 years of monitoring, were analyzed. By UK consensus threshold H3.5, patients experienced a mean 1.3 hypoglycemic episodes per day. Per cent time hypoglycemic increased from 1.2% to 3.3% to 6.9% when threshold changed from H3.0 to H3.5 and H3.9. Merged data showed periodicity of hypoglycemia risk in 24-hour periods in all patients.Conclusions We have evaluated a large dataset to provide a comprehensive picture of the frequency and patterns of hypoglycemia for patients with CHI in the UK. These data establish a baseline risk of hypoglycemia by CGM and provide a framework for clinical management and clinical trial design.Data are available upon reasonable request. Data were used as part of a service evaluation and thus are not freely available for research purposes. If data were required to be shared, this could be organized with the appropriate legalities and ethical approval.