Resolving Hypoglycemia: Learnings from the HypoResolve Project
Researchers at the 2023 ATTD conference discussed research findings about hypoglycemia and potential solutions for resolving low blood sugar events.
The state of hypoglycemia, when glucose value falls below 70 mg/dL, can be extremely dangerous to people with diabetes if they do not address it. If someone with diabetes does not treat low glucose levels, they can experience severe hypoglycemia, in which glucose levels are so low that mental or physical functioning is impaired and the person requires assistance.
The three categories of hypoglycemia are:
- Level 1: Hypoglycemia alert level when blood glucose level falls below 70 mg/dL
- Level 2: Serious/clinically important when blood glucose level falls below 54 mg/dL
- Level 3: Severe hypoglycemia defined as impaired cognitive function requiring external assistance.
It’s possible for someone to be aware that they are experiencing low blood glucose, which is known as normal awareness of hypoglycemia (NAH). Conversely, impaired awareness of hypoglycemia (IAH) is when someone does not know they are low. IAH puts someone at much higher risk for experiencing severe hypoglycemia since they don’t realize what’s happening and therefore cannot take proper action.
Data demonstrate the importance of hypoglycemia in management. “People with diabetes identify reducing hypoglycemic events as a meaningful improvement in their diabetes,” said Dr. Simon Helle. professor of clinical diabetes at the University of Sheffield Medical School.
According to the 2020 study, people with diabetes would be willing to pay $73 each month for a reduction from one serious low each week and 5-7 mild-to-moderate lows to 2-4 moderate lows each week. They said they would also be willing to pay $5 each month for a 0.5% improvement in their A1C. This difference shows the prioritization of low events.
Because of the amount of information needed to further understand and address hypoglycemia, projects like HypoResolve and HypoMETRICS explore the impact of hypoglycemia in people with diabetes.
Dr. Pratik Choudhary, senior lecturer and consultant in diabetes at King’s College of London, said, “Hypoglycemia means different things to different people,” meaning that low episodes impact everyone in a different way.
Additionally, he said, the HypoMETRICS study has so far demonstrated the difference between “patient reported hypoglycemia” and “CGM detected hypoglycemia.”
According to study data, about 62% of sensor-detected hypoglycemia events were also reported by people with type 1 diabetes and 38% were not reported. This difference in detection means that “CGM alone cannot differentiate between people with normal awareness of hypoglycemia or impaired awareness of hypoglycemia,” said Choudhary.
Both sensor-detected hypoglycemia and patient-reported hypoglycemia need to be identified in one’s management and care in order to properly treat future hypoglycemic events. These findings may “influence how we educate people with diabetes about the effects of hypoglycemia,” said Chouhdary.