Endocrine Abstracts

Introduction: Type 1 diabetes (T1DM) is an autoimmune disease that requires insulin treatment from the time of diagnosis. The evidence about the influence of lifestyle on the course of T1DM is increasing. The aims of our study were to evaluate the lifestyle of a group of boys with type 1 diabetes and to study their glycemic control.

Method: This is a descriptive cross-sectional study conducted at the National Institute of Nutrition in Tunis. The level of physical activity (PA) was evaluated using the International Physical Activity Questionnaire (IPAQ). A nutritional survey was done for each patient using the 24-hour recall method. A high-carbohydrate diet was defined as a carbohydrate intake greater than 5 g/Kg of ideal weight/Day. The ideal weight was determined by the CREFF formula. We analyzed the CGM data for each patient and we calculated the coefficient of variability of glucose (CV), mean of glycemic excursions (MAGE) and the mean of daily differences (MODD).

Results: We included 37 boys with type 1 diabetes in our study, with an average age of 17±2 years old. The mean duration of diabetes was 6± 4 years. The average body mass index was 19.5±2 kg/m^²; two patients in the study population were overweight. Among our patients, 13.5% had a high level of PA, 48.6% had a medium level and 37.8% had a low level PA. The average total caloric intake was 2432±665 Kcal/d, distributed as follows:2676±300 Kcal/d for patients with high PA, 2440±800 Kcal/d for patients with medium level of PA and 2320± 562 Kcal/d for patients with low level PA. The mean carbohydrate intake was 291±145 g/d (46±7% of the total caloric intake). However, 28.6% of patients had a high-carbohydrate diet. In addition the average protein intake was 84±29 g/d (14±4% of the total caloric intake)and the average fat intake was 98.5±31g/d (36±5% of the total caloric intake). The mean glycated hemoglobin level was 9.8±1.8%, only two patients had Hb1Ac ≤7%. Time in range varied between 4 and 88% with an average of 37±18%. Time below range was between 0 and 36% with an average of 6.6±8%. The mean of time within range was 55.9±21%.The average coefficient of variability of glucose, was 40±10%, that of MAGE was 150±45 mg/dl. Moreover the majority of patients (91.9%) had a MAGE > 65 mg/dl. The average MODD was 85±40 mg/dl.

Conclusion: Dietary measures are difficult to apply in adolescents and this can induce poor glycemic control. Nutritional education must be regularly maintained associated to insulin therapy.