Table 2.
Patients’ characteristics and glycemic control among patients with episodes of nocturnal hypoglycemia, according to the presence of PHNH
| Patients with episodes of nocturnal hypoglycemia (n = 580) | |||
|---|---|---|---|
| Variable |
No PHNH (n = 332) |
≥ 1 episode of PHNH (n = 248) |
P value |
| Demographic variables | |||
| Sex (man) | 190 (57.2) | 148 (59.7) | 0.554 |
| Age (years) | 49 (15) | 46 (13) | 0.019 |
| Metabolic and lifestyle variables | |||
| Duration of diabetes (years) | 22 (13) | 22 (12) | 0.601 |
| LADA (yes)a | 48 (14.5) | 21 (8.5) | 0.027 |
| Body mass index (kg/m2)b | 26.9 (4.8) | 26.6 (4.7) | 0.375 |
| Ever smoker (yes)c | 142 (43.7) | 99 (41.8) | 0.650 |
| Current smoker (yes)c | 65 (20.0) | 58 (24.5) | 0.205 |
| Advanced chronic complications of diabetes | |||
|
Microvascular complications (yes) Diabetic retinopathy (yes) Diabetic kidney disease (yes) Diabetic peripheral neuropathy (yes) |
45 (13.6) 39 (11.7) 19 (5.7) 12 (3.6) |
50 (20.2) 44 (17.7) 12 (4.8) 13 (5.2) |
0.033 0.041 0.640 0.340 |
|
Macrovascular complications (yes) Myocardial infarction (yes) Heart failure (yes) Cerebrovascular disease (yes) Peripheral artery disease (yes) |
27 (8.1) 11 (3.3) 10 (3.0) 10 (3.0) 13 (3.9) |
27 (10.9) 11 (4.4) 5 (2.0) 6 (2.4) 16 (6.5) |
0.259 0.484 0.455 0.666 0.166 |
| Insulin treatment | |||
| Total daily dose of insulin (IU/kg/day)d | 0.65 (0.29) | 0.67 (0.22) | 0.022 |
| Basal insulin alone (yes) | 9 (2.7) | 2 (0.8) | 0.175 |
| Percentage of basal insulin for patients on basal-bolus therapy (%)e | 53.0 (13.6) | 53.9 (13.2) | 0.534 |
| Next-generation basal insulin for patients on basal-bolus therapy (yes)e | 273 (90.7) | 217 (92.7) | 0.400 |
| Next-generation rapid-acting insulin for patients on basal-bolus therapy (yes)e | 90 (29.9) | 81 (34.6) | 0.246 |
| Open-loop insulin pump (yes) | 17 (5.1) | 12 (4.8) | 0.878 |
| Continuous glucose monitoring use | |||
| Hypoglycemia alarm set (yes) | 235 (70.8) | 184 (74.2) | 0.364 |
| Hypoglycemia alarm threshold (mg/dL)f | 73.5 (7.1) | 73.1 (6.6) | 0.625 |
| Scans per day (n) | 10.2 (6.0) | 10.9 (6.4) | 0.115 |
| Glycemic control (continuous glucose monitoring) | |||
| Time above range, level 2 (> 250 mg/dL) (%) | 10.3 (10.3) | 13.6 (11.2) | < 0.001 |
| Time above range, level 1 (181–250 mg/dL) (%) | 22.3 (9.0) | 24.2 (6.8) | 0.033 |
| Time in range (70–180 mg/dL) (%) | 62.7 (16.2) | 57.1 (13.8) | < 0.001 |
| Time below range, level 1 (54–69 mg/dL) (%) | 3.9 (3.5) | 4.1 (3.3) | 0.245 |
| Time below range, level 2 (< 54 mg/dL) (%) | 0.5 (1.2) | 0.8 (1.6) | 0.013 |
| Glucose management indicator (%) | 7.1 (0.6) | 7.3 (0.6) | < 0.001 |
| Glucose variability (%) | 37.1 (5.9) | 39.4 (6.2) | < 0.001 |
| Hypoglycemic events (n)g | 8.2 (6.4) | 9.8 (6.5) | 0.001 |
| Duration of hypoglycemia (min)h | 107 (56) | 92 (37) | 0.003 |
| Days with nocturnal hypoglycemic episodes (n)i | 3.0 (2.2) | 3.9 (2.2) | < 0.001 |
| Days with diurnal hypoglycemic episodes (n)j | 6.9 (3.3) | 7.7 (3.2) | 0.007 |
Data are expressed as mean and standard deviation (within parentheses) or as absolute numbers and percentage (within parentheses). P-values were obtained using the Mann–Whitney test (for numerical variables) and the chi-square test (for categorical variables; with Yates’ correction applied when the expected frequency in any cell was < 5)
aSubtype of antibody-positive type 1 diabetes that is defined as adult-onset diabetes (> 30 years at diagnosis) with absence of insulin requirement for at least 6 months after diagnosis
bData available for 577 patients
cData available for 562 patients
dData available for 561 patients
eData available for 535 patients given that only patients on basal-bolus therapy were selected for these analyses. The percentage of basal insulin was calculated as daily dose of basal insulin/(daily dose of basal insulin + daily dose of bolus insulin)
fData available for 419 patients given that only patients with the hypoglycemia alarm set were selected
gNumber of hypoglycemic episodes with a duration of more than 15 min during the 14-day period
hData available for 561 patients as only patients with at least 1 hypoglycemic event of more than 15 min of duration were selected (duration of hypoglycemia is considered 0 min in those with no hypoglycemic events)
iNumber of nights (0:00 am to 6:00 am period) during the 14-day period in which the LibreView graph recorded at least 1 hypoglycemic episode, regardless of its duration
jNumber of days (6:01 am to 23:59 pm period) during the 14-day period in which the LibreView graph recorded at least 1 hypoglycemic episode, regardless of its duration
PHNH, post-hypoglycemic nocturnal hyperglycemia. IU, international units. LADA, latent autoimmune diabetes in adults