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DOI: 10.1055/s-0030-1262874
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York
Relationship Between HbA1c on Target, Risk of Silent Hypoglycemia and Glycemic Variability in Patients with Type 2 Diabetes Mellitus
Publication History
received 26.04.2010
first decision 13.07.2010
accepted 21.07.2010
Publication Date:
18 January 2011 (online)
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Abstract
Objective: We aimed to compare time spent at low glucose level (silent hypoglycemia, glucose <3.0 mmol/l) and glycemic variability in patients who reached HbA1c <7.0% with those who did not.
Research Design and Methods: In 108 type 2 diabetic patients the interstitial glucose concentration was measured with CGMS (Continuous Glucose Monitoring System) over 72 h. Patients were divided in group 1 with an HbA1c <7.0% (n=63) and group 2 with an HbA1c≥7.0% (n=45).
Results: 24% in group 1 experienced silent hypoglycemia vs. 11% in group 2 (n. s.), duration of silent hypoglycemia over 48 h was 27±71 min vs. 7±36 min (n. s.). This was also valid for the subgroups treated with insulin. Patients in group 2 had a significantly higher standard deviation of average glucose (2.3±0.8 vs. 1.3±0.6; p<0.001) and MAGE (mean amplitude of glycemic excursions) (4.8±2.1 vs. 2.6±1.1; p<0.001).
Conclusion: Silent hypoglycemia tended to occur more often and to last longer in patients with HbA1c <7%. However, patients with HbA1c >7% had a higher glycemic variability. HbA1c >7% wasn’t a reliable indicator of lower risk of hypoglycemia.
Key words
CGMS - hypoglycemia - glycemic variability
References
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Correspondence
M. Hanefeld
GWT-TUD GmbH
Center for clinical studies
Fiedlerstraße 34
01307 Dresden
Germany
Phone: + 49/351/4400 580
Fax: + 49/351/4400 581
Email: hanefeld@gwtonline-zks.de