Endocrine Abstracts

Introduction: There is no doubt that continuous monitoring systems can improve diabetes control. The aim of the study was to determine typical deviations of glucose and mistakes in insulin treatment, self-control, predisposing to the poor blood control.

Materials and methods: 30 patients with type 1 diabetes were included, mean age 21±7.8, mean age of diabetes manifestation 19.2±13.9 years, mean duration oа diabetes – 15.3±7.5. Including criteria: type 1 diabetes, basal-bolus regimen of insulin injection, HbA1c above individual target level for more than 1 year. Excluding criteria: acute diseases, failure of chronic diseases. We conducted constant glucose monitoring (CGM) using blinded system (patients didn’t see results during monitoring). CGM lasted 7 days in all patients and 1988 readings were measured by the device. According to the protocol patients should have recorded in provided for them diary carbohydrates (CH) amount, doses of insulin and measure glucose levels with glucometer at least 4 times a day.

Results: We revealed statistically significant difference between HbA1c (8.9±2.1%) measured in laboratory during CGM and calculated HbA1c (7.0±1.2%) measured during monitoring (according to the results of standardized protocol) (P < 0.05). As far as patients were instructed to record CH, insulin doses and blood glucose levels measured at least 4 times a day it’s possible to assume that one or all parts of this daily routine are lost in patients with diabetes who didn’t achieve target HbA1c. Increased blood glucose levels during night (47.0±29.0%) were associated with higher HbA1c during CGM (r =0.5, P < 0.05). The higher dose of basal insulin (21.3±9.1U) was associated with higher HbA1c measured in laboratory (r =0.5, P < 0.05) and increased glucose during night (r =0.5, P < 0.05).

Conclusion: 1. Calculated HbA1c and laboratory HbA1c differ for approximately 2% in patients with poorly controlled diabetes. 2. Nocturnal hyperglycemia is associated with higher HbA1c level and higher doses of basal insulin.