Endocrine Abstracts

Introduction: One of the often-discussed topics in the management guidelines for Type 1 Diabetes Mellitus (T1DM) is the ideal time gap that should exist between patient check-ups. A period of three to six months is usually recommended, which sometimes is difficult to achieve due to the high number of patients. But to what extent does the time gap between appointments in the follow-up of T1DM patients affect their diabetes’ control?

Objectives: To know the average time gap between T1DM patients’ appointments in our hospital; and to quantify the correlation between that time gap and HbA1c, and the correlation between those variables and severe hypoglycemia.

Methods: A retrospective cohort study of 130 T1DM patients who attended to the Endocrinology consults in Hospital Clínico Lozano Blesa, Zaragoza (Spain) was conducted, correlating the time gap between appointments with HbA1c and Clarke score, as well with the presence of severe hypoglycemia. Statistical analysis was performed using Pearson correlation coefficient and Student’s T-test.

Results: A positive correlation was observed between the time gap between check-ups and the HbA1c (correlation coefficient 0.357, P < 0.01), the HbA1c increase from the previous check-up correlation coefficient 0.564, P < 0.01), and Clarke’s questionnaire score (correlation coefficient 0.472, P = 0.026), as well as between HbA1c and Clarke test score (correlation coefficient 0.387, P = 0.04). Moreover, the HbA1c and time-gap mean was significantly higher in those patients who had an episode of severe hypoglycemia (8.05% and 149 days) compared to those who did not (7.32% and 109 days; P = 0.017).

Conclusion: Lower HbA1c and Clarke test scores were observed when the time gap between type 1 diabetics’ follow-up is shorter, thus achieving better control of their diabetes and having less risk of long-term complications. On the other hand, there is also a higher HbA1c mean in patients who presented severe hypoglycemia, which indicates the importance of time in range and glycemic variability and not only the mean glucose levels estimated by HbA1c.