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

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ABSTRACT 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