1292-P: Continuous Glucose Monitor Use Protects against the Negative Impact of Fear of Hypoglycemia on Sleep Parameters in Adolescents with Type 1 Diabetes

Abstract

Background: Adolescents with type 1 diabetes (T1D) are vulnerable to sleep difficulties that may negatively affect mental health and glycemic control. Fear of hypoglycemia (FOH) may contribute to these sleep problems. Although parental FOH has been associated with poor sleep quality in children with T1D, little is known about the relationship between adolescent FOH and sleep outcomes. Objective: To examine the association between adolescent FOH and sleep parameters and assess how continuous glucose monitor (CGM) use influences these relationships. Methods: Adolescents ages 14-18 years with T1D completed questionnaires evaluating FOH (Child Hypoglycemia Fear Survey) and sleep parameters (Pittsburgh Sleep Quality Index). Meaningful CGM use was defined as reporting using the device ≥ 50% of the time. Analyses included linear regression and T-tests. Results: One hundred adolescents (56 female) with a median (IQR) age of 16.3 (15.3,17.6) years and duration of T1D of 5.7 (2.5, 9.5) years completed surveys, and 45 used CGM. FOH was inversely associated with sleep duration (r=0.25, p=0.01) and quality (r=0.22 p=0.03), and positively associated with sleep disturbances (r=0.24, p=0.01). A stratified analysis showed that the inverse relationship between FOH and sleep duration (r=0.29, p=0.03), as well as the association with sleep disturbances (r=0.31, p=0.02) was only significant among those not using CGM. Furthermore, average sleep duration was longer in those using CGM [7.5 hours with CGM vs. 6.8 hours without, p=0.02] and the associations between FOH and sleep duration or disturbance were not significant among CGM users. Conclusions: Among adolescents with T1D, FOH is associated with reduced sleep duration, poor sleep quality and increased sleep disturbance. Our findings suggest that CGM use could mitigate the negative contribution of FOH on various sleep parameters in this population, a previously unrecognized benefit. Disclosure T.A. Hitt: None. J. Smith: None. E.L. Forth: None. P. Garren: None. D. Olivos-Stewart: None. M. De La Vega: None. F. Stuart: None. C.P. Hawkes: None. S.M. Willi: Advisory Panel; Self; Boehringer Ingelheim International GmbH. Research Support; Self; Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Tolerion, Inc. Other Relationship; Self; Caladrius Biosciences, Inc. J. Gettings: None.

Unmanned Aerial Vehicle Mediated Drug Delivery for First Aid

“…[ 6 ] As severe hypoglycemia often leads to sudden fainting or occurs while sleeping at night, [ 7 ] the continuous glucose monitoring system (CGMS) on diabetic people that is able to real‐time alert hypoglycemia could serve as the danger signal source to pair the uFAST for timely administration of the glucose‐elevating drug (glucagon). [ 8 ] In order to ensure accurate dosing of glucagon, a dual‐mode microneedle patch (DM‐MN) is developed to realize an immediate release of a basal dose as well as a sustained glucose‐dependent release of a subsequent dose. In an insulin‐overdosing hypoglycemic diabetic minipig model, we further substantiate that the uFAST integrated with DM‐MN could facilitate a timely aid in minutes, to alleviate the risk of severe hypoglycemia.…”