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Is silent hypoglycemia part of ideal glycemic control in DM1 patients? - hypoglycemic state by CGMS vs. glycemic average

BACKGROUND: To evaluate the impact of silent hypoglycemic state in glycemic control in type 1 diabetic patients (DM1) by CGMS. METHODS: 87 DM1 patients (45%M/55%F) submitted to a 72h CGMS profile were classified in 4 groups. It was analyzed: unrecognized hypoglycemia (<70mg/dL); duration time of silent hypoglycemia in which patients were classified into G1 (<5%), G2 (5-10%), G3 (10-20%) and G4 (>20%) of hypoglycemic state by CGMS; A1c and mean capillary glucose (MCG) in each group. RESULTS: The silent hypoglycemia was detected in 64.5% of patients and nighttime episodes of hypoglycemia lasted longer (min) than daytime episodes in all groups (p<0.001). It was verified 41.4% of patients under than 5% of time in hypoglycemic state, 21.8% between 5-10%, 23% between 10-20% and 13.8% with more than 20% of CGMS in silent hypoglycemia. This data showed significant decreased in MCG when the duration time of silent hypoglycemia was longer (p=0.006). CONCLUSION: The silent hypoglycemia is common in DM1 patients and most frequently in night time period. To take an average glycemia of 120-160mg/dL in these patients, it was necessary a 10-20% of CGMS period in silent hypoglycemia in these patients.

Silent hypolgycemia; A1c; Average glycemia; Diabetes mellitus type 1


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