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June 7, 2026Diabetes

Heart rate changes during sensor-detected hypoglycemia showed poor correlation with autonomic symptom scores (correlation factor -0.2) in patients with type 2 diabetes.

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Why the study?

Does change in heart rate correlate with hypoglycemic symptoms during sensor-detected hypoglycemia in patients with type 2 diabetes?

Population

28 participants with type 2 diabetes and intact hypoglycemia awareness, median age 62 years, median HbA1c…

Design

Cohort, blinded sensors

Follow-up

10 weeks

Key result

Heart rate changes during sensor-detected hypoglycemia showed poor correlation with autonomic symptom scores (correlation factor -0.2) in patients with type 2 diabetes.

Authors

VKVAIOS D. KOUTROUKASGMGILBERTE MARTINE-EDITHATAikaterina Tziannou

Discussion

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Overview

Heart rate changes during sensor-detected hypoglycemia show poor correlation with symptomatic episodes in type 2 diabetes, suggesting symptom perception may not be solely mediated by epinephrine-driven heart rate changes.

Key Points

  • This study aims to assess the relationship between heart rate changes and symptomatic episodes of hypoglycemia in individuals with type 2 diabetes.
  • Utilized data from the Hypo-METRICS study with 28 participants wearing sensors for 10 weeks.
  • Recorded hypoglycemia symptoms and heart rate data using specialized applications and FitBit devices.
  • Analyzed correlations between heart rate changes and various hypoglycemia-related factors.
  • Identified 41 symptomatic hypoglycemic events with a median heart rate change of 1.59 beats per minute.
  • Correlations between heart rate changes and autonomic symptom scores were low (e.g., -0.2 for ASS).
  • Findings suggest that the perception of hypoglycemic symptoms may not be directly related to heart rate changes.

Study Design

Type

Observational (n=28)

Structured PICO

Does change in heart rate correlate with hypoglycemic symptoms during sensor-detected hypoglycemia in patients with type 2 diabetes?

P
Population
28 participants with type 2 diabetes and intact hypoglycemia awareness who wore blinded continuous glucose monitors for 10 weeks.
E
Exposure
Blinded continuous glucose monitors and FitBit devices worn for 10 weeks, with real-time recording of hypoglycemia symptoms on a bespoke app.
O
Outcome
Correlation between change in heart rate (ΔHR) and autonomic/neuroglycopenic symptom scores during symptomatic sensor-detected hypoglycemia (<54mg/dL).surrogate

Main Result

Effect estimate: Correlation factor -0.2

Heart rate changes during sensor-detected hypoglycemia show poor correlation with symptomatic episodes in type 2 diabetes, suggesting symptom perception may not be solely mediated by epinephrine-driven heart rate changes.

Cite This Study

KOUTROUKAS et al. (2026) conducted an observational in Type 2 diabetes (n=28). Change in heart rate (ΔHR) was evaluated on Correlation between median ΔHR and autonomic symptom score (ASS) (Correlation factor -0.2). Heart rate changes during sensor-detected hypoglycemia showed poor correlation with autonomic symptom scores (correlation factor -0.2) in patients with type 2 diabetes.

synapsesocial.com/papers/6a250b2d7def13d035e1b282https://doi.org/10.2337/db26-1038-or
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