A great deal of work is required to achieve normalised blood glucose levels in people with type 1 diabetes, if an average level of <8.5 mmol/L (<154 mg/dl) and time-in-range of 70% are used as benchmarks of excellent control. A continuous glucose monitoring study of ‘normal’ glucose levels in people without diabetes found that they spent 97% of time within a tight range, defined as 3.9–7.8 mmol/L (70–140 mg/dl), with a mean blood glucose level of 5.5 mmol/L (99 mg/dl). Each day participants were hypoglycaemic for 30 minutes, spending just 4 minutes with blood glucose levels >8.9 mmol/L (>160 mg/dl) on average. Time spent in hypoglycaemia was negligible.
A total of 153 non-diabetic adults and children aged 6 years or older who had a baseline HbA1c of 32 mmol/mol (5.1%) participated in the study. Metrics on overall glucose control, hyperglycaemia and hypoglycaemia were gathered over 10 days using the Dexcom G6 monitor.
Dr Roy Beck, who is based at the Jaeb Center, presented the results of the study by Dr Anne Peters and colleagues at the University of Southern California. He told EASD delegates that the data further support consensus that 3 mmol/L (54 mg/dl) is a meaningful cut-off point for hypoglycaemia.
Attempts to achieve remission, or at least a substantial improvement in glycaemic control, should be the initial focus at type 2 diabetes diagnosis.
9 May 2024