Skip Navigation



QJM Advance Access published online on July 2, 2009
QJM, doi:10.1093/qjmed/hcp082
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
102/9/603    most recent
hcp082v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Woodward, A.
Right arrow Articles by Gill, G.V.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Woodward, A.
Right arrow Articles by Gill, G.V.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2009. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Nocturnal hypoglycaemia in type 1 diabetes—frequency and predictive factors

A. Woodward1, P. Weston2, I.F. Casson1 and G.V. Gill1

From the 1Department of Diabetes and Endocrinology, University of Liverpool, Clinical Sciences Centre, Aintree University Hospital, L9 1AE and 2Department of Diabetes and Endocrinology, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, UK

Address correspondence to A. Woodward, Department of Diabetes and Endocrinology, University of Liverpool, Clinical Sciences Centre, Aintree University Hospital, L9 7AL, UK. email: a.woodward{at}liverpool.ac.uk; annwoodward4{at}btinternet.com

Received 2 December 2008 and in revised form 27 May 2009


  Abstract

Background: Nocturnal hypoglycaemia (NH) remains a problem in type 1 diabetes and spontaneous asymptomatic NH may be a risk factor for sudden death (‘Dead in Bed’ syndrome).

Aims: To explore whether any predictive relationship exists between the average or time-specific glycaemia and the occurrence of NH.

Methods: Twenty-five healthy patients with type 1 diabetes underwent two separate overnight periods of continuous glucose monitoring (CGM) using a MMT-7002 Medtronic MiniMed System. There was a 6-week interval before the second monitoring period. CGM glucose levels recorded between 23:00 and 08:00 h defined the nocturnal period and recorded glucose monitoring levels <3.5 mmol/l for at least 10 min during this time-defined NH. A CGM recording at 23:00 h and 08:00 h were taken as the bedtime and fasting glucose levels, respectively.

Results: The mean ± SD age was 37 ± 7 years and duration of diabetes 13 ± 7 years; 16 (64%) were on long-acting analogue insulin. Forty-nine CGM data sets were recorded. Fourteen episodes of NH occurred in 12 patients (Group 1), 13 patients (Group 2) had no NH. Group 1 (NH) had a lower mean bedtime glucose recorded compared with Group 2 (7.7 ± 4.3 vs. 11.4 ± 4.0 mmol/l, P = 0.0035). Fasting glucose level was also lower in Group 1 following the occurrence of NH (P = 0.014). There was no difference in the type of insulin used between the two groups.

Conclusions: Our data show that in normal day to day settings, NH is common and that the bedtime glucose level is a significant predictive factor.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.