Optimal management of diabetes requires not only the achievement of glycaemic targets, but also the analysis of blood glucose fluctuations potentially leading to hyper- and hypoglycaemia.

Most glycaemic variability metrics are inherently biased towards hyperglycaemia, but the well-established low blood glucose index (LBGI) focusses entirely on low blood glucose excursions.

In this study, we used daily self-monitored plasma glucose (SMPG) profiles to assess the LBGI and to predict hypoglycaemia risk in the EDITION 2, EDITION 3 and SENIOR trials, each of which investigated the use of insulin glargine 300 U/mL (Gla-300) versus insulin glargine 100 U/mL (Gla-100) in type 2 diabetes.

In all three studies, the LBGI correlated well with the reported number of documented symptomatic hypoglycaemia events and could be used to identify those at risk of hypoglycaemia.

Using the LBGI as a metric of hypoglycaemia risk, a lower risk was observed for Gla-300 versus Gla-100 in all three trials, corroborating previous analyses of pharmacokinetic and pharmacodynamic profiles.