Three Patterns of Blood Glucose Changes Seen in Type 1 Diabetes: Study


It’s long been known that people with type 1 diabetes[1] are susceptible to both hyperglycemia[2] (high blood glucose) and hypoglycemia[3] (low blood glucose), due to both the disease itself and how the body responds to doses of insulin. But some people tend to experience more highs than lows or vice versa, and at different times during the day.

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Now, a new study suggests that blood glucose variability can be grouped into three overall patterns, based on a population of teenagers with type 1 diabetes.

Published in the journal Pediatric Diabetes[4], the study included 234 participants ages 13 to 16, each of whom had a recent HbA1c level[5] of at least 8%. As part of the study, they wore a continuous glucose monitoring (CGM) system[6] for 7 days without being able to see their glucose readings on the device.

As noted in a Healio[7] article on the study, the researchers used the CGM data and computer algorithms to identify three broad patterns of unhealthy blood glucose levels among the participants.

In Cluster 1, 141 participants (60.3%) experienced severely high glucose levels during the day, a low incidence of hypoglycemia, and the lowest overall variability in levels. In Cluster 2, 53 participants (22.7%) had severely high blood glucose overnight, a moderate incidence of hypoglycemia during the day (median of 4 episodes daily), and moderate variability overall. In Cluster 3, 40 participants (17.1%) had moderately high blood glucose most of the time, alternating with a high incidence of hypoglycemia (median of 8 episodes daily), and the highest overall variability during both day and night.

Members of Cluster 3 experienced an increase in HbA1c over 18 months of follow-up, from an average of 8.7% to 9.6%. Average HbA1c in the other groups remained stable.

The researchers noted that this study marks a starting point for understanding the factors that determine which pattern of glucose irregularities someone experiences, and that “enhanced understanding of demographic, behavioral, and clinical characteristics that contribute to” these patterns “may reveal strategies to improve treatment.”

Want to learn more about recent Type 1 diabetes research? Read “Reversing Type 1 Diabetes: New Research From Boston Children’s Hospital,”[8] “Can a Very Low-Carb-Diet Help People With Type 1 Diabetes?”[9] and “Type 1 Diabetes Research: What’s New?”[10]

Quinn Phillips[11]Quinn Phillips

A freelance health writer and editor based in Wisconsin, Phillips has a degree in government from Harvard University. He writes on a variety of topics, but is especially interested in the intersection of health and public policy.

Endnotes:
  1. type 1 diabetes: https://www.diabetesselfmanagement.com/diabetes-resources/definitions/type-1-diabetes/
  2. hyperglycemia: https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/managing-hyperglycemia/
  3. hypoglycemia: https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/understanding-hypoglycemia/
  4. Pediatric Diabetes: https://onlinelibrary.wiley.com/doi/10.1111/pedi.12856
  5. HbA1c level: https://www.diabetesselfmanagement.com/managing-diabetes/blood-glucose-management/h-b-a-1-c/
  6. continuous glucose monitoring (CGM) system: https://www.diabetesselfmanagement.com/videos/what-is-the-difference-between-type-1-and-type-2-diabetes/
  7. Healio: https://www.healio.com/endocrinology/diabetes/news/online/%7B584b829b-b453-4f99-8cb8-09bc33d86dcb%7D/cgm-machine-learning-reveal-dysglycemia-phenotypes-in-type-1-diabetes
  8. “Reversing Type 1 Diabetes: New Research From Boston Children’s Hospital,”: https://www.diabetesselfmanagement.com/blog/reversing-type-1-diabetes-new-research-boston-childrens-hospital/
  9. “Can a Very Low-Carb-Diet Help People With Type 1 Diabetes?”: https://www.diabetesselfmanagement.com/blog/can-very-low-carb-diet-help-people-type-1-diabetes/
  10. “Type 1 Diabetes Research: What’s New?”: https://www.diabetesselfmanagement.com/about-diabetes/general-diabetes-information/diabetes-research-whats-new-2/
  11. [Image]: //cdn.diabetesselfmanagement.com/2018/12/QP_headshot.jpg

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