Large changes in day-to-day blood sugar levels and the risk of hypoglycemia

The aim of this study was to investigate the association between the day-to-day self-monitored blood glucose level differences and the risk of hypoglycemia in insulin-treated patients with type 1 and type 2 diabetes. The study found that bigger differences in day-to-day blood glucose levels were associated with a higher risk of hypoglycemia in these patients.

Patients with type 1 (T1D) and type 2 diabetes (T2D) have high blood glucose levels. Therefore, they both require blood sugar-lowering therapies, such as insulin. However, this comes with a risk of lowering blood sugar levels too much. This is called hypoglycemia. This is very dangerous and has major negative effects on a patient’s health.

Changes in blood glucose levels from one day to the next are called glycaemic variability (GV). High GV can lead to an increased risk of complications. The relationship between high GV and the risk of hypoglycemia is not known.

This study combined data from two separate trials including a total of 1,221 patients with T1D and T2D. The association between day-to-day (self-monitored) GV and hypoglycemia was analyzed. The study also compared the day-to-day GV between two different insulin treatments: insulin degludec (Tresiba) and insulin glargine (Lantus).

Patients with high fasting GV had a higher number of hypoglycemic episodes. A doubling of day-to-day GV was associated with a more than 2-fold increase in the risk of hypoglycemia.

Insulin degludec was associated with a 4% lower day-to-day fasting GV than insulin glargine in patients with T1D. In patients with T2D, insulin degludec was associated with a 10% lower day-to-day fasting GV than insulin glargine.

This study concluded that high GV is associated with a higher risk of hypoglycemia. The authors also determined that insulin degludec is associated with lower GV compared to insulin glargine.

Both trials included in this study were funded by Novo Nordisk, the manufacturer of insulin degludec.

If you have large changes in your blood sugar levels from one day to the next, you should consider speaking to your doctor.