281-OR: Directness and Sustainability of rtCGM Effects on Hypoglycemia: A Secondary Analysis of the Hypode Study

The HypoDE study demonstrated that real-time continuous glucose monitoring (rtCGM) can reduce biochemical as well as clinical hypoglycemia in people with hypoglycemia problems. However, it is not clear how quick a reduction of low glucose values via rtCGM occurs and how sustainable this is. We analyzed the rtCGM group of the HypoDE study and compared the 4-week baseline phase with masked rtCGM to three 4-week intervals within the therapy/outcome phase (T/O phase) with open rtCGM (Dexcom G5). Only participants with no recent experience with CGM were included. At baseline, 6.5±6.2% of the glucose values of the 75 participants were below 70 mg/dl and 2.5±3.3% were below 54 mg/dl. In the first week, these percentages dropped significantly to 2.9±0.4%, respectively 0.7±1.3%. For the remainder of the T/O phase, these percentages stayed stable (not crossing the lower 95% CI interval of the baseline values; see Figure). Time-in-Range (TIR) improved significantly in the first 12 weeks and then started to drop to baseline level. rtCGM results in an immediate and significant reduction of level 1 (< 70 mg/dl) and level 2 (< 54 mg/dl) hypoglycemic values. This initial effect can be sustained throughout the entire study period without wear off. The avoidance of hypoglycemia was not associated with a deterioration of TIR. Disclosure D. Ehrmann: Advisory Panel; Self; Medtronic. Speaker's Bureau; Self; Abbott, Berlin-Chemie AG, Dexcom, Inc. L. Heinemann: Consultant; Self; Roche Diabetes Care. Research Support; Self; Dexcom, Inc. Stock/Shareholder; Self; Profil Institute for Metabolic Research, ProSciento. G. Freckmann: Advisory Panel; Self; Abbott, Novo Nordisk Pharma GmbH, Sensile Medical AG. Consultant; Self; Metronom Health Europe, Roche Diabetes Care, Sanofi. Speaker's Bureau; Self; Ascensia Diabetes Care, Dexcom, Inc., Ypsomed AG. D. Waldenmaier: None. N. Hermanns: Advisory Panel; Self; Abbott. Board Member; Self; Eli Lilly and Company. Research Support; Self; Abbott, Berlin-Chemie AG, Dexcom, Inc., Roche Diabetes Care. Speaker's Bureau; Self; Berlin-Chemie AG, Dexcom, Inc., Novo Nordisk A/S. Funding Dexcom, Inc.