Table 3.
Hypoglycemic episodes and events over 24 hours and at night (12 to 6 am)
| [A] Healthy control | [B] PBH-RYGB | [C] Non-Surg Hypo | [D] Pre-DM | [E] T2D | P value (paired)* | P value (overall)** | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| n | 38 | 40 | 20 | 14 | 5 | [A] vs [B] | [A] vs [C] | [B] vs [C] | [B] vs [E] | |
| Hypoglycemic episodes per day | ||||||||||
| 24 hours | ||||||||||
| Mild (<70 mg/dL) hypoglycemic episodes | 1.1 ± 1.4 | 2.2 ± 1.9 | 1.4 ± 1.8 | 0.3 ± 0.3 | 0.2 ± 0.2 | 0.002 | 0.355 | 0.224 | 0.002 | <0.0001 |
| Severe (<54 mg/dL) hypoglycemic episodes | 0.1 ± 0.1 | 0.5 ± 0.6 | 0.2 ± 0.2 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.002 | 0.136 | 0.415 | 0.027 | <0.001 |
| Nighttime (12 – 6am) | ||||||||||
| Mild (<70 mg/dL) hypoglycemic episodes | 0.2 ± 0.2 | 0.7 ± 0.6 | 0.3 ± 0.4 | 0.0 ± 0.0 | 0.0 ± 0.0 | <0.001 | 0.064 | 0.459 | 0.003 | <0.0001 |
| Severe (<54 mg/dL) hypoglycemic episodes | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | <0.001 | 0.001 | 0.972 | 0.082 | <0.001 |
| Duration of hypoglycemic events | ||||||||||
| 24 hours | ||||||||||
| Max duration of mild hypoglycemic event (min) | 80.0 ± 89.0 | 100.0 ± 85.3 | 135.0 ± 114.9 | 42.5 ± 55.6 | 15.0 ± 22.2 | 0.072 | 0.077 | 0.505 | 0.006 | 0.003 |
| Mean duration of mild hypoglycemic event (min) | 27.2 ± 14.4 | 38.9 ± 23.7 | 39.6 ± 19.9 | 21.5 ± 19.4 | 10.0 ± 14.8 | 0.004 | 0.030 | 0.956 | 0.006 | 0.002 |
| Max duration of severe hypoglycemic event (min) | 12.5 ± 18.5 | 32.5 ± 40.8 | 32.5 ± 48.2 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.008 | 0.073 | 0.925 | 0.008 | <0.001 |
| Mean duration of severe hypoglycemic event (min) | 10.0 ± 14.8 | 19.5 ± 16.2 | 23.0 ± 33.4 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.043 | 0.084 | 0.653 | 0.009 | <0.001 |
| Nighttime (12 – 6 AM) | ||||||||||
| Max duration of mild hypoglycemic event (min) | 15.0 ± 22.2 | 65.0 ± 77.8 | 82.5 ± 89.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.001 | 0.034 | 0.975 | 0.003 | <0.001 |
| Mean duration of mild hypoglycemic event (min) | 9.2 ± 13.6 | 33.1 ± 33.4 | 33.0 ± 31.9 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.001 | 0.047 | 0.609 | 0.003 | <0.001 |
| Max duration of severe hypoglycemic event (min) | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.002 | 0.008 | 0.966 | 0.059 | <0.001 |
| Mean duration of severe hypoglycemic event (min) | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.0 ± 0.0 | 0.001 | 0.009 | 0.892 | 0.059 | <0.001 |
Data are median ± median absolute deviations (MAD). *P value from paired comparison using Wilcoxon test. **P value from comparison across all groups using Kruskal-Wallis (ANOVA). A mild or severe episode is defined as ≥ 15 minutes of consecutive glucose values below 70 mg/dL or 54 mg/dL respectively. A mild or severe event is defined as ≥ 5 minutes of consecutive glucose values below 70 mg/dL or 54 mg/dL respectively.
Abbreviations: PBH-RYGB, post-bariatric hypoglycemia after RYGB; Pre-DM, prediabetes; T2D, type 2 diabetes.