Endocrine Abstracts

Factors associated with high glucose variability in patients with type 1 diabetes High glycemic variability is recognized as a risk factor for degenerative complications and hypoglycemia. The factors affecting glycemic variability in diabetic patients need to be clarified. Our aim was to determine factors associated with high GV in adolescents patients with type 1 diabetes.

Method: This is a cross-sectional analytical study, conducted at the National Institute of Nutrition in Tunis during the year 2022, including adolescents with type 1 diabetes, 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 (CV)by dividing the SD by the mean glucose and multiplying by 100 to get a percentage.

Results: Our study included 90 patients with type 1 diabetes, of which 53 are girls and 37 are boys. The average age was 16.6±2., and the mean duration of diabetes was 6.7±3.5 years. The average CV was 40±12%, and 62, 2% of patients had a CV greater than 36%. The age of patients, and duration of diabetes were positively correlated with CV (P=0.001 and P=0.002 respectively), however, age at onset of diabetes was negatively correlated with CV (r=-0.3; P=0.004). Patients with higher glycemic variability took significantly higher doses of basal insulin (P=0.03). Patients on insulin analogues had a significantly lower CV than patients on NPH insulin (P=0, 021). A significant association was observed between the presence of lipodystrophy and a cv >36% (P=0, 024). However, no statistically significant relationship was found between the presence of autoimmune diseases such as adrenal insufficiency, celiac disease and hypothyroidism) and glycemic variability.

Conclusion: Several factors are involved in the genesis of glycemic variability in type 1 diabetics. Recognizing these factors enables us to act on modifiable factors to limit glycemic variability.