Introduction and Objective: Hypoglycemia causes an adrenergic response (AR) associated with epinephrine rise. We evaluated if change in heart rate (ΔHR), used as surrogate for AR, can distinguish between symptomatic and asymptomatic sensor-detected hypoglycemia (SDH), and factors affecting this, in type 2 diabetes. We focused on awake, symptomatic SDH<54mg/dL from people with intact awareness (Gold≤3), theorizing that any change would be better identified in this group.Methods: We used data from the Hypo-METRICS study. Participants (n=28; median age 62yr (IQR 17), median HbA1c 7.5% (IQR 0.7%), sensor use 39%) wore blinded sensors for 10 weeks and recorded hypoglycemia symptoms and their intensity real-time on a bespoke app. HR data and sleep status were obtained from FitBit devices. We used Spearman’s correlation in R between averaged HR 30min before and after SDH onset, autonomic and neuroglycopenic symptom scores (ASS/NSS), hypoglycemia duration, SDH nadir, rate of glucose change (ΔRoG) before SDH, and SDH rate/week.Results: We identified 41 symptomatic SDH events. Median ΔHR was 1.59 beats per min. Correlation factor between median ΔHR and ASS was -0.2, median ΔHR and NSS 0.08, median ΔHR and ΔRoG -0.23. Low correlation was found among the rest of the variables.Conclusion: HR changes during SDH showed poor correlation with symptomatic episodes, suggesting perception of symptoms may be mediated via other mechanisms from epinephrine.
V.D. Koutroukas: Other – 1) YDEF-Lilly scholarship to attend EASD, Sep 2024. 2) EASD Robert Turner course, partially funded by Lilly, Apr 2025.; Ended; Lilly. Other – EASD Robert Turner course, partially funded by Lilly, Apr 2025.; Ended; European Association for the Study of Diabetes. Other – travel and accommodation fees for ATTD, Mar 2024; Ended; KelCon GmbH. G. Martine-Edith: None. A. Tziannou: None. J.J. Thomas: None. P. Divilly: Speaker’s Bureau; Ended; A. Menarini Diagnostics. Advisory Panel; Ended; Dexcom, Inc. Speaker’s Bureau; Ended; Novo Nordisk. P. Choudhary: Advisory Panel; Current; Medtronic. Speaker’s Bureau; Current; Medtronic. Research Support; Current; Medtronic. Consultant; Current; Medtronic. Speaker’s Bureau; Current; Abbott. Advisory Panel; Current; Abbott. Research Support; Current; Abbott. Speaker’s Bureau; Current; Dexcom, Inc. Advisory Panel; Current; Dexcom, Inc. Research Support; Current; Dexcom, Inc. Consultant; Current; Dexcom, Inc. Speaker’s Bureau; Current; Insulet Corporation. Advisory Panel; Current; Insulet Corporation. Research Support; Current; Insulet Corporation. Consultant; Current; Insulet Corporation. Speaker’s Bureau; Current; Sanofi. Consultant; Current; Sanofi. Speaker’s Bureau; Current; Lilly. Advisory Panel; Current; Lilly. Consultant; Current; Lilly. Advisory Panel; Current; Ypsomed AG. Advisory Panel; Ended; Embecta. Speaker’s Bureau; Current; Roche Diabetes Care. Research Support; Current; Roche Diabetes Care. Consultant; Current; Roche Diabetes Care. Advisory Panel; Current; Vertex Pharmaceuticals Incorporated. Consultant; Current; Glooko, Inc., Cambridge Mechatronics Ltd, vTv Therapeutics.
Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement 777460
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