1817-PUB: CGM-Derived Metrics and HbA1c in Adults with Type 2 Diabetes (T2D) on Different Insulin Treatment Regimens Not Meeting Glycemic Targets

Abstract

Objective: Despite advances in treatment strategies, many individuals with T2D treated with insulin still struggle with inadequate glycemic control. The aim was to describe CGM-derived metrics and HbA1c for adults with T2D and HbA1c ≥7.5% (≥58 mmol/l) using different insulin treatment regimens; basal insulin only or multiple daily injections (MDI). Methods: Baseline characteristics of participants with T2D entering a randomized controlled trial on the efficacy of using CGM were analyzed including CGM-derived metrics from 10 days blinded CGM (Dexcom G6). Results: Included were 96 adults (men 61.5%, age 61 (54-67) years and BMI 30.7 (26.7-35.7) kg/m2, all median (+IQR)). Compared to adults on basal insulin only, the MDI treated had a longer diabetes duration of 22 (19-25) vs 18 (14-22) years, a higher HbA1c 9.2 (8.6-9.7) vs 8.3 (7.8-9.1) % and a lower C-peptide 396 (217-630) vs 745 (504-1178) pmol/l. There were no differences in time in range or mean sensor glucose. In contrast, the MDI treated had less time above range (28 (21-32) vs 33 (25-42) %) but a higher coefficient of variation (32 (26-36) vs 26 (23-31)%) and a higher time below range (<3.0 mmol/l). Conclusion: These results suggest that while MDI treatment may be associated with higher HbA1c levels and greater glycemic variability, this is not consistently reflected in all CGM-derived metrics. Disclosure N.Lind: None. M.B.Christensen: Speaker's Bureau; Novo Nordisk A/S, Sanofi. K.Nørgaard: Advisory Panel; Medtronic, Novo Nordisk, Research Support; Medtronic, Dexcom, Inc., Novo Nordisk, Zealand Pharma A/S, Speaker's Bureau; Medtronic, Novo Nordisk, Stock/Shareholder; Novo Nordisk.