När temperaturerna stiger ökar risken för hypoglykemi vid typ 1-diabetes
Stigande temperaturer verkar avsevärt öka den kortsiktiga risken för hypoglykemi bland vuxna med typ 1-diabetes (T1D), enligt ny forskning.
En analys av mer än 32 miljoner kontinuerliga glukosmätare (CGM) från nästan 700 vuxna med T1D i Storbritannien visade en 26 % högre risk för hypoglykemi vid 25 °C än vid 13 °C. Hypoglykemi definierades som en glukosnivå < 3,9 mmol/L (70 mg/dL).
Resultaten publicerades i augusti 2026 års nummer av Diabetes Care
Läs hela studien open source free
https://diabetesjournals.org/care/article/49/8/1323/164650/The-Association-Between-Ambient-Temperature-and
av ett team lett av Harriet E. Daultrey, MBBS, PhD, vid Department of Global Health and Infection vid Brighton and Sussex Medical School i Brighton samt Environment & Health Modelling Lab vid London School of Hygiene and Tropical Medicine i London. båda i England.
”Våra resultat ger robusta, individuella bevis som stöder kliniskt styrda insulinjusteringar under perioder med förhöjd omgivningstemperatur, särskilt > 25 °C,” skrev Daultrey och kollegor.
Viktiga punkter
• 25 °C vs 13 °C: risk för hypoglykemi ↑ 26 % hos vuxna med typ 1-diabetes.
• >32 miljoner CGM-avläsningar från 679 vuxna i Storbritannien; medelålder: 46,4 år.
• Värmeeffekt omedelbar: risk samma dag ↑; återgick till baslinjen med 7 dagar.
• Säsongsmönster: lägst risk sent vinter/tidig vår; Topp på sommaren.
• Clinical implications: consider temp in insulin adjustment, HCL algorithms, education.
• How does heat alter insulin absorption and action?
Which T1D subgroups have heat-related hypoglycemia risk?
Can hybrid closed-loop algorithms incorporate ambient temperature?
“These results also suggest ambient temperature may be considered a variable within hybrid closed-loop insulin-delivery algorithms and included in structured education, especially during increasingly frequent severe-weather warnings. They also highlight the importance of preparing clinical teams and healthcare systems to manage the increased risk of hypoglycemia during hotter weather.”
Potential mechanisms linking heat exposure to hypoglycemia include changes in insulin absorption and action, the authors noted.
Millions of CGM Readings Analyzed
The study included 679 individuals with T1D and 32,966,282 CGM readings collected between February 23, 2017, and August 8, 2024. Participants had a mean age of 46.4 years and a mean T1D duration of 23.7 years.
The researchers used a case time series design to assess the longitudinal association between ambient temperature and hypoglycemia. The model controlled for factors that remained constant or changed slowly over time, such as socioeconomic status and BMI.
The mean daily temperature during the study period was 12.0 °C (53.6 °F), with temperatures ranging from -3.7 °C to 28.7 °C. The mean daily glucose level was 10.1 mmol/L (182 mg/dL).
Peak Risk: Summer and Mondays
The researchers observed strong seasonal patterns, with lower odds of hypoglycemia in late winter and early spring, followed by a peak during the summer.
The lowest risk occurred on Mondays. The odds then increased over the course of the week and peaked toward the weekend, with a significant odds ratio of 1.14 on Saturdays compared with Mondays.
Increases in hypoglycemia were observed during both hot and cold weather, but the association was stronger for heat. The net odds ratio was 1.26 at 25 °C compared with 13 °C.
The effect was immediate, with an odds ratio of 1.10 for same-day exposure to 25 °C compared with 13 °C. Risk returned to baseline after 7 days.
Sekundära analyser, inklusive de som använde det kontinuerliga dagliga medelvärdet av CGM-värden och en lägre hypoglykemitröskel, bekräftade samma mönster.
”Dessa fynd är särskilt relevanta för personer med T1D som redan har högre risk för hypoglykemi, såsom de med glykeminivåer nära målet, med lägre HbA1c eller med nedsatt hypoglykemimedvetenhet,” skrev Daultrey och kollegor.
”För personer som använder flera dagliga injektioner kan proaktiv minskning av basalt insulin krävas i förväntad temperaturökning för att minimera hypoglykemi.”
From www.medscape.com
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