Person‐Reported and Continuous Glucose Monitoring ( CGM ) Recorded Hypoglycaemia in People With Insulin‐Treated Type 2 Diabetes and Mild to Moderate Chronic Kidney Disease; Post Hoc Analysis From the Hypo‐ METRICS Study
BACKGROUND AND AIMS: People with diabetes and chronic kidney disease (CKD) may be at increased risk of iatrogenic hypoglycaemia. We compared rates of sensor-detected (SDH) and person-reported hypoglycaemia (PRH) in people with insulin-treated Type 2 diabetes (T2D) with and without CKD in the Hypo-METRICS study. MATERIALS AND METHOD: Insulin-treated T2D patients with > 1 hypoglycaemic episode within the last 3 months wore a blinded continuous glucose monitor (CGM) and recorded PRH on the bespoke Hypo-METRICS app for 10 weeks. SDH was defined as per consensus guidelines. The participants were grouped based on estimated glomerular filtration rate (eGFR), that is CKD 1 (eGFR ≥ 90 mL/min; n = 117), CKD 2 (eGFR 60-89 mL/min; n = 140), and CKD 3 (eGFR 30-59 mL/min; n = 56). We used descriptive statistics, Kruskal-Wallis rank sum tests, and a negative binomial models to control for confounders. RESULTS: In total, 313 participants with T2DM were included. Median age increased with declining eGFR (p < 0.001). Median (IQR) events per week for SDH < 3.9 mmol/L were 1.72 (0.66-3.43) in CKD 1, 2.12 (0.85-4.55) in CKD 2, and 2.22 (1.09-4.57) in CKD 3 (p = 0.12). For SDH < 3.0 mmol/L, these rates were 0.20 (0.00-0.50), 0.21 (0.10-0.61), and 0.20 (0.00-0.71), respectively (p = 0.88). PRH events had medians of 1.05 (0.40-2.12), 1.31 (0.61-2.42), and 1.28 (0.68-2.25) for CKD 1, CKD 2, and CKD 3 (p = 0.24). CONCLUSION: In people with insulin-treated T2DM and CKD stages 2 or 3, the rates of SDH and PRH do not significantly differ from those in people without CKD. TRIAL REGISTRATION: ClinicalTRials.gov: NCT04304963.
Authors
- Ulrik Pedersen‐Bjergaard (ORCID: https://orcid.org/0000-0003-0588-4880)
- Namam Ali (ORCID: https://orcid.org/0000-0003-4302-7820)
- Julia Katharina Mader (ORCID: https://orcid.org/0000-0001-7854-4233)
- Éric Renard (ORCID: https://orcid.org/0000-0002-3407-7263)
- Julie Maria Bøggild Brøsen (ORCID: https://orcid.org/0000-0001-7361-4407)
- Rory J. McCrimmon (ORCID: https://orcid.org/0000-0002-3957-1981)
- Simon Heller (ORCID: https://orcid.org/0000-0002-2425-9565)
- Mark L. Evans (ORCID: https://orcid.org/0000-0001-8122-8987)
- Gilberte Martine‐Edith (ORCID: https://orcid.org/0000-0002-4592-3680)
- Daniel Malmsiø (ORCID: https://orcid.org/0000-0002-0057-742X)
- Natalie Zaremba (ORCID: https://orcid.org/0000-0002-1720-1621)
- Patrick Divilly
- Bastiaan de Galan
- Pratik Choudhary
- Allan A. Vaag
Institutions
- University of Copenhagen (DK)
- Steno Diabetes Centers (DK)
- Radboud University Nijmegen (NL)
- University of Leicester (GB)
- University of Dundee (GB)
- King's College London (GB)
- Université de Montpellier (FR)
- Medical University of Graz (AT)
- University of Cambridge (GB)
- Copenhagen University Hospital (DK)
- Radboud University Medical Center (NL)
- Maastricht University (NL)
- Zealand University Hospital (DK)
- Centre Hospitalier Universitaire de Montpellier (FR)
- St. Vincent's University Hospital (IE)
- King's College School (GB)
- University of Sheffield (GB)
Publication Details
- Journal
- Diabetes Obesity and Metabolism
- Published
- 2026-09-01
- DOI
- https://doi.org/10.1111/dom.71247
- Primary Topic
- Diabetes Management and Research
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Juvenile Diabetes Research Foundation International
- Eli Lilly and Company
- Sanofi
- Leona M. and Harry B. Helmsley Charitable Trust
- University of Dundee
- European Federation of Pharmaceutical Industries and Associations
- European Commission
- Radboud Universiteit
- Novo Nordisk
- Université de Montpellier
- Abbott Diabetes Care
- Menzies Centre for Australian Studies, King's College London, University of London