Endocrine Abstracts

Introduction: Type 1 diabetes is an endocrinopathy due to insulin deficiency. Its treatment consists in administering an exogenous insulin simulating the physiological secretion. The objective of this study was to evaluate glycemic variability in a group of adolescents with type 1 diabetes treated with human insulin.

Method: This is a cross-sectional study, including type1 diabetic patients treated with human insulin, who underwent continuous glucose monitoring (CGM) for 6 days. 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). The Time Above Range (TAR) defined as >180 mg/dl, the Time Below Range (TBR) defined as <70 and <54 mg/dl and the Time In Range (TIR) were derived From CGM.

Results: We included 36 patients with type 1 diabetes with an average age of 17±1.8 years old. Nineteen patients were female and seventeen were male. The average duration of diabetes was 6.6± 4.6 years. The average total insulin dose was 55.6 ± 18 UI (0.92±0.31UI/Kg), the average total dose of rapid insulin was 20 ± 8 UI (0.33± 0.12 UI/Kg) and that of basal insulin was 35±12UI (0.6±0.22UI/Kg). The average CV was 38 ±11%, and more than half of the patients (58.3%) had a coefficient of variability greater than 36%. In addition, the mean MAGE was 141±46 mg/dl and only 2 patients had a MAGE ≤ 65 mg /dl. Furthermore, the average MODD was 91±42 mg/dl and 77.8% of patients had MODD ≥60 mg/dl. Time in range varied from 4 to 88% with an average of 37±19%. Time below range varied from 0% to 36% with an average of 7±9%. The mean of time above range was 55±23%. TIR was negatively correlated with total insulin dose (r=-0.41, P=0,013). TAR was positively correlated with the dose of rapid insulin (r=0,34 P=0,039). The dose of rapid insulin was positively correlated with TAR (r=0,34 P=0,039) and negatively correlated with TIR (r=-0.47 P= 0,004).

Conclusion: In our study we concluded that the majority of patients are overdosed in basal insulin and have high glycemic variability.