Nocturnal Glucose Patterns with and without Hypoglycemia in People with Type 1 Diabetes Managed with Multiple Daily Insulin Injections

Nocturnal Glucose Patterns with and without Hypoglycemia in People with Type 1 Diabetes Managed with Multiple Daily Insulin Injections Full article

Journal

Journal of Personalized Medicine
ISSN: 2075-4426

Output data

Year: 2023, Volume: 13, Number: 10, Article number : 1454, Pages count : 14 DOI: 10.3390/jpm13101454

Tags

type 1 diabetes; hypoglycemia; continuous glucose monitoring; clustering; prediction

Authors

Kladov Danil E. ^1,2 , Berikov Vladimir ^1,3 , Semenova Julia F. ¹ , Klimontov Vadim V. ^1,4

Affiliations

1	Laboratory of Endocrinology, Research Institute of Clinical and Experimental Lymphology—Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences (RICEL—Branch of IC&G SB RAS), 630060 Novosibirsk, Russia
2	Department of Mathematics and Mechanics, Novosibirsk State University, 630090 Novosibirsk, Russia
3	Laboratory of Data Analysis, Sobolev Institute of Mathematics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia
4	V. Zelman Institute of Medicine and Psychology, Novosibirsk State University, 630090 Novosibirsk, Russia

Funding (1)

Russian Science Foundation

20-15-00057

Nocturnal hypoglycemia (NH) is a potentially dangerous and underestimated complication of insulin therapy. In this study, we aimed to determine which patterns of nocturnal glucose profiles are associated with NH in patients with type 1 diabetes (T1D) managed with multiple daily insulin injections. A dataset of continuous glucose monitoring (CGM) recordings obtained from 395 adult subjects with T1D was used for modeling. The clustering of CGM data was performed using a hierarchical clustering algorithm. Ten clusters without hypoglycemia and six clusters with NH episode(s) were identified. The differences among the clusters included initial and final glucose levels, glucose change during the night, and the presence of uptrends or downtrends. Post-midnight hyperglycemia was revealed in 5 out of 10 clusters without NH; in patterns with downtrends, initially elevated glucose prevented NH episodes. In clusters with initially near-normal glucose levels and downtrends, most episodes of NH were observed from midnight to 4 a.m.; if glucose was initially elevated, the episodes occurred at 2–4 a.m. or 4–6 a.m., depending on the time of the start of the downtrend. The results demonstrate the diversity of nocturnal glucose profiles in patients with T1D, which highlights the need for a differentiated approach to therapy adjustment.

Kladov D.E. , Berikov V. , Semenova J.F. , Klimontov V.V.
Nocturnal Glucose Patterns with and without Hypoglycemia in People with Type 1 Diabetes Managed with Multiple Daily Insulin Injections
Journal of Personalized Medicine. 2023. V.13. N10. 1454 :1-14. DOI: 10.3390/jpm13101454 WOS Scopus РИНЦ OpenAlex

Submitted:	Sep 3, 2023
Accepted:	Sep 26, 2023
Published print:	Sep 29, 2023
Published online:	Sep 29, 2023

Web of science:	WOS:001095135700001
Scopus:	2-s2.0-85175448487
Elibrary:	54618441
OpenAlex:	W4387230491

DB	Citing
OpenAlex	4
Elibrary	6
Scopus	5
Web of science	3