Relationship between glycated hemoglobin level and duration of hypoglycemia in type 2 diabetes patients treated with sulfonylureas: A multicenter cross-sectional study

Abstract

Aims/introduction: Sulfonylurea-related hypoglycemia increases the risk of cardiovascular sequela, such as cardiac arrhythmia. This study aimed to clarify the relationship between the level of glycated hemoglobin (HbA_1c ) and the duration of hypoglycemia in type 2 diabetes patients treated with sulfonylureas.

Materials and methods: Glucose levels in the enrolled patients (n = 300) were investigated with a professional continuous glucose monitoring device in the outpatient setting at six diabetes centers in Japan.

Results: A total of 269 participants completed the study. The duration of hypoglycemia with glucose values of <54 mg/dL was significantly longer in patients with an HbA_1c level of ≤6.4% than in those with an HbA_1c level of ≥8.0%, and that of hypoglycemia with glucose values of <70 mg/dL was significantly longer in patients with an HbA_1c level of ≤6.4%, 6.5-6.9% or 7.0-7.4% than in those with an HbA_1c level of ≥8.0%. Patients with an HbA_1c level of ≤6.4% were exposed to glucose values of <70 mg/dL for >10% of the time in daily life (6.8 ± 5.6 min/h). The duration of hypoglycemia with glucose values of <70 mg/dL was longer at night than during the daytime, and the nadir of glucose values occurred between 03.00 and 05.00 hours irrespective of HbA_1c level. The duration of hypoglycemia was associated with the duration of diabetes and sulfonylurea dose.

Conclusions: The duration of hypoglycemia was inversely correlated with HbA_1c level and was longer during the night-time than daytime in type 2 diabetes patients treated with sulfonylureas.

Keywords: Continuous glucose monitoring; Hypoglycemia; Sulfonylureas.