Endocrine Abstracts

Introduction: Glycemic variability (GV), defined as an integral component of glucose homeostasis, is emerging as an important metric to consider when assessing glycemic control in clinical practice. The aims of our study were to study glycemic variability among a group of adolescents with type 1 diabetes and to determine the factors influencing this parameter.

Method: This is a cross-sectional analytical study, conducted at the National Institute of Nutrition in Tunis during the year 2021, including type 1 diabetic patients who underwent continuous glucose monitoring for 6 days. We analyzed the continuous glucose monitoring CGM data for each patient and we calculated the coefficient of variability by dividing the S.D. by the mean glucose and multiplying by 100 to get a percentage.

Results: Our study included 81 patients with type 1 diabetes, of which 47 are girls and 34 are boys. The average age was 16.6±2 years and the mean duration of diabetes was 6.26±4 years. The age of onset of diabetes varies between 1 and 18 years with an average of 10.4±4 years. Patients with glycated hemoglobin (HB1AC) greater than 7% had an average coefficient of glucose variability (CV) of 39±12% while those with a HB1AC less than 7% had an average CV of 40±11%. The majority of patients had glycated hemoglobin greater than 7% (89% of patients). Furthermore; More than half of the patients had a coefficient of variation of glucose (CV) greater than 36%. The average CV was 39±12%. The CV was significantly correlated to the age of patients (r=0.25 P=0.025) and to the duration of diabetes (r=0.35 P=0.001). However, CV was negatively correlated with age of diabetes onset (r=−0.23 P=0.036). The glycated hemoglobin was correlated to the CV (r=0.22 P=0.049).

Conclusion: HbA1c was traditionally considered as the gold standard for assessing glycemic control. GV is a more meaningful measure of glycemic control than HbA1c in clinical practice, and is without doubt now being recognized.