Current guidelines recommend 15–20 g of carbohydrate (CHO) for treatment of mild to moderate hypoglycemia. However, these guidelines do not account for reduced insulin during suspensions with predictive low-glucose suspend (PLGS). We assessed insulin suspensions, hypoglycemic events, and CHO treatment during a 20-h inpatient evaluation of an investigational system with a PLGS feature, including an overnight basal up-titration period to activate the PLGS. Among 10 adults with type 1 diabetes, there were 59 suspensions; 7 suspensions were associated with rescue CHO and 5 with hypoglycemia. Rescue treatment consisted of median 9 g CHO (range: 5–16 g), with no events requiring repeat CHO. No rescue CHO were given during or after insulin suspension for the overnight basal up-titration. To minimize rebound hyperglycemia and needless calorie intake from hypoglycemia overtreatment, updated guidance for PLGS systems should reflect possible need to reduce CHO amounts for hypoglycemia rescue associated with an insulin suspension. The clinical trial was registered with ClinicalTrials.gov (NCT03890003).

中文翻译：

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预测性低葡萄糖悬浮液需要较少的碳水化合物补充来挽救低血糖症：需要重新审视当前的低血糖症治疗指南

目前的指南推荐 15-20 g 碳水化合物 (CHO) 用于治疗轻度至中度低血糖症。然而，这些指南没有考虑到预测性低葡萄糖悬浮液 (PLGS) 悬浮液期间胰岛素的减少。我们在对具有 PLGS 特征的研究系统进行 20 小时住院评估期间评估了胰岛素悬浮液、低血糖事件和 CHO 治疗，包括用于激活 PLGS 的过夜基础上滴定期。在 10 名成人 1 型糖尿病患者中，有 59 名悬浮液；7 种悬浮液与挽救 CHO 相关，5 种与低血糖有关。抢救治疗包括中位数 9 g CHO（范围：5-16 g），没有需要重复 CHO 的事件。在胰岛素悬液期间或之后，在过夜基础上滴定期间未给予救援 CHO。为了最大限度地减少因低血糖过度治疗而导致的反弹性高血糖和不必要的卡路里摄入，PLGS 系统的更新指南应反映可能需要减少与胰岛素悬浮液相关的低血糖拯救的 CHO 量。该临床试验已在 ClinicalTrials.gov (NCT03890003) 注册。