Lower versus standard sucrose dose for treating hypoglycemia in patients with type 1 diabetes mellitus in therapy with predictive low glucose suspend (PLGS) augmented insulin pumps: A randomized crossover trial in Santiago, Chile.

Abstract

BACKGROUND AND AIMS\nRecommended hypoglycemia treatment in adults with T1D consists of 15\xa0g of rapid absorption carbohydrates. We aimed to evaluate the response to fewer carbohydrates for treating hypoglycemia in patients with T1D on insulin pumps with predictive suspension technology (PLGS).\n\n\nMETHODS\nT1D patients on insulin pumps with PLGS were randomized to receive 10 or 15\xa0g of sucrose per hypoglycemia for two weeks (S10 and S15 groups, respectively) when capillary blood glucose (BG) was <70\xa0mg/dL, with crossover after two weeks. Evolution of capillary BG, active insulin, and suspension time were assessed.\n\n\nRESULTS\n59 hypoglycemic episodes were analyzed, 33 in S10 and 26 in S15. Baseline BG in S10 was 54.3\xa0±\xa07.7\xa0mg/dL versus 56.9\xa0±\xa08.8 in S15 (p\xa0=\xa00,239). Active insulin, present in 85% of the episodes, and PLGS suspension time were similar between groups. BG at 15\xa0min was 77\xa0mg/dL in S10 and 95\xa0mg/dL in S15 (p\xa0=\xa00.0007). In S10, 21% of the episodes required to repeat the treatment after 15\xa0min compared with none on S15, with a RR of 0,79 (95% CI 0.66, 0.940, p\xa0=\xa00,014) for successfully treating the episode. Sensor glucose was significantly different from BG at the moment of the hypoglycemia and control 15\xa0min after treatment. No severe hypoglycemia and no rebound hyperglycemia occurred in neither group.\n\n\nCONCLUSIONS\nA hypoglycemia treatment protocol with a lower dose of sucrose might be insufficient despite PLGS technology. Our data suggest that standard doses of sucrose should still be recommended.