688-P: Comparing Rates of Sensor-Detected Hypoglycaemia and Patient-Reported Hypoglycaemia by Method of Glucose Monitoring: The Hypo-METRICS Trial
Authors: DIVILLY PATRICK , MARTINE-EDITH GILBERTE , MAHMOUDI ZEINAB , ZAREMBA NATALIE , SOEHOLM UFFE , DE GALAN BASTIAAN E. , PEDERSEN-BJERGAARD ULRIK , MCCRIMMON RORY J. , RENARD ERIC , HELLER SIMON R. , EVANS MARK , AMIEL STEPHANIE A. , CHOUDHARY PRATIK , SEIBOLD ALEXANDER 
Published: May 2022

Continuous glucose monitoring (CGM) allows greater detection of hypoglycemia. We compared rates and duration of sensor detected hypoglycemia (SDH) and patient reported hypoglycemia (PRH) in people with type 1 diabetes (T1D) and normal awareness of hypoglycemia (NAH) (Gold score &gt;4) using either flash or capillary blood glucose (CGB) monitoring. We included 91 participants (70 CGM vs. 21 CBG) with T1D with &gt;1 hypoglycemic episode in the last month. They used blinded CGM in addition to their usual glucose monitoring and recorded PRH (symptomatic event that resolved on carbohydrate ingestion, or a self-measured glucose &lt;72 mg/dl) in real time on a smartphone app for weeks. Sleep status was obtained using wrist wore actigraphy. Median (IQR) time in range (TIR) , 59.4 (17.4) vs 60.1 (16.9) % p=.54 and time below range, 4.6 (5.3) vs. 3.6 (5.7) % p=0.39, were not different. There were no significant differences in rates or duration of SDH &lt;70 mg/dl or &lt;54 mg/dl (table 1) . Rates of PRH were higher in the CGM group while awake, 2.9 (2.6) vs. 1.9 (2.6) episodes/week p=.039, with no difference during sleep. Median duration of SDH &lt; 40mg/dl while awake was longer, 20.1 (12.7) vs. 43.2 (7.0) minutes p=.0068. For a given TIR, people with T1DM have similar hypoglycemia exposure regardless of mode of monitoring. CGM enhances awareness of events and shortens events &lt; 40mg/dl whilst awake.

Disclosure
P.Divilly: None. S.R.Heller: Advisory Panel; Eli Lilly and Company, Medtronic, Mylan N.V., Zealand Pharma A/S, Zucara Therapeutics, Other Relationship; Eli Lilly and Company, Research Support; Dexcom, Inc., Speaker’s Bureau; Novo Nordisk A/S. M.Evans: Advisory Panel; Pila Pharma, Zucara Therapeutics, Other Relationship; Abbott Diabetes, Dexcom, Inc., Medtronic, Novo Nordisk, Research Support; AstraZeneca, Sanofi, Speaker’s Bureau; Lilly Diabetes. S.A.Amiel: Advisory Panel; Medtronic, Novo Nordisk, Other Relationship; Sanofi. P.Choudhary: Advisory Panel; Abbott Diabetes, Lilly Diabetes, Medtronic, Research Support; Novo Nordisk, Speaker’s Bureau; Dexcom, Inc., Glooko, Inc., Insulet Corporation, Sanofi. A.Seibold: Employee; Abbott Diabetes, Stock/Shareholder; Abbott. G.Martine-edith: Other Relationship; Novo Nordisk. Z.Mahmoudi: Employee; Novo Nordisk A/S. N.Zaremba: None. U.Soeholm: Research Support; Novo Nordisk A/S. B.E.De galan: Research Support; Novo Nordisk. U.Pedersen-bjergaard: Advisory Panel; Novo Nordisk A/S, Sanofi. R.J.Mccrimmon: Advisory Panel; Novo Nordisk, Sanofi, Research Support; Diabetes UK, European Union, MedImmune. E.Renard: Consultant; Abbott, AstraZeneca, Boehringer Ingelheim International GmbH, Dexcom, Inc., Insulet Corporation, LifeScan, Lilly, Novo Nordisk, Roche Diabetes Care, Sanofi, Tandem Diabetes Care, Inc.

Funding
Innovative Medicines Initiative (777460)