1938-P: When Treatment Overshoots: Real-World Prevalence of Rebound Hyperglycemia

Introduction and Objective: Hypoglycemia requires prompt treatment to prevent adverse outcomes. However, overcorrection with excessive carbohydrate intake can cause a subsequent spike in glucose, known as rebound hyperglycemia (RhyperG). RhyperG contributes to glycemic variability, making it important to identify and address effectively. Continuous glucose monitoring (CGM) enables detection of RhyperG by capturing post-treatment glucose spikes. Here, we present an analysis to assess the real-world prevalence of RhyperG. Methods: Data from 14188 Freestyle Libre 2 Flash glucose monitoring system users, confirmed to be on rapid-acting insulin through Novopen dosing records, were analyzed. Qualifying hypoglycemia episodes were low glucose alarms followed by a user-initiated scan. RhyperG was defined as the onset of hyperglycemia (CGM value > 180 mg/dL) within two hours of the end of the hypoglycemia episode. Results: Among 1,913,552 qualifying hypoglycemia episodes, 24% were followed by RhyperG. On average, individuals experienced 2.2 RhyperG episodes per week, with a mean duration of 79 minutes. As shown in the figure, these episodes were more frequent during waking hours. Conclusion: RhyperG was frequently observed following user-aware hypoglycemic episodes among insulin-treated individuals, indicating a high real-world prevalence. Its higher occurrence during daytime hours suggests the influence of corrective carbohydrate intake. These findings underscore CGM as a tool to identify rebound episodes and improve hypoglycemia management. Disclosure N. Singh: Employee; Current; Abbott Diabetes. A. Bhattacharya: Employee; Current; Abbott Diabetes. B. Olson: Employee; Current; Abbott Diabetes. G. Hayter: Employee; Current; Abbott Diabetes.