Endocrine Abstracts

Background: The use of Flash Glucose Monitoring (FGM) for the management of type 1 diabetes mellitus (T1D) is rapidly increasing.

Aims: To assess the longitudinal evolution of glycated haemoglobin (HbA1c) and body mass index (BMI) with the use of FGM in patients with T1D; to determine predictive factors of benefit with the use of this technology.

Materials and methods: Retrospective study of T1D patients, using FGM ≥6 months and treated with multiple daily doses of insulin. Patients whochanged the type of basal insulin, began/suspended oral hypoglycaemic drugs or were/became pregnancy during the analysed period were excluded.

Results: 179 patients included, 52.5% males. The median age (Md) was 43.0 (P25 31.0; P75 52.0) years old, median duration of disease was 18.0 (P25 10.0; P75 28.0) years and 33.5% were treated with functional insulin therapy. The initial HbA1c was Md 7.9% (P25 7.2; P75 8.8); 49.1% with initial HbA1c ≥ 8%. The initial BMI was 24.0 Kg/m² (P25 21.9; P75 26.2); 39% were overweight/obese. FGM usage time was 6 months in 25.7%, 12 months in 34.6% and ≥ 18 months in 39.7% patients. FGM was associated with a significant improvement in HbA1c during the first year, with Md HbA1c 7.6% (P25 7.0; P75 8.3) at 6 months and 7.7% (P25 6.95; P75 8.5) at 12 months (P < 0.05). At 6 months, there was a significant increase in the number of patients with HbA1c < 7% (16.1% vs 25.0%) and a significant reduction in the number of patients with HbA1c ≥ 8% (49.1 vs 37.1%) (P < 0.05). In multivariate longitudinal regression analysis, initial HbA1c 8.0–8.9% (HR 1.886; CI 1.321; 2.450) and ≥9.0% (HR 3.108, CI 2.454; 3.761) and initial BMI 25.0–29.9 kg/m² (HR –0.397; CI –0.793; –0.001) were predictors of greaterHbA1c reduction. BMI increased significantly during the 12 months follow-up, especially during the second 6 months, with BMI Md 23.8 (P25 21,9; P75 26,2) kg/m² and 24.0 (P25 22.0; P75 26.2) kg/m² at 6 and 12 months, respectively (P < 0.05). In multivariate longitudinal regression analysis, initial BMI 25.0–29.9 kg/m² (HR 4.319, CI 3.185; 5.453) and ≥ 30 kg/m² (HR 8.112, CI 3.919; 12.306) were predictors of greater weight gain.

Conclusion: In the first year of FGM use, there was a significant improvement in HbA1c, mainly in patients with a previous worst glycemic control. When starting FGM, weight control strategies should be considered, especially in overweight/obese patients.