2460-PUB: Metabolic Control in Three-Year Follow-Up in Guangdong Patients with Type 1 Diabetes Mellitus

Abstract

Previous data showed that poor metabolic control existed in Guangdong type 1 diabetes mellitus(T1DM) patients. Thus, scheduled follow-ups were initiated in our diabetic clinic. This study aimed to assess the effect of scheduled management and explore related factors. From June 2011 to November 2018, 342 patients with T1DM registered in our diabetic clinic. Clinical data was obtained, HbA1c and plasma lipids were measured at enrollment and then once a year. Patients who had been followed-up for three years were included. A total of 201 patients (59.7% female) were analyzed, with median age of 26.9(18.1,35.5) years and diabetic duration of 5.6(0.4,8.8) years. HbA1c levels fell from 8.0±2.0% at enrollment to 7.3±1.2% in the third year progressively (P<0.001) and the rate of age-specific target achievement raised from 38.0% to 47.2% (P=0.031).Serious hypoglycemia frequency decreased from 0.6(0,0.2) to 0.3(0,0) per month (P=0.046). Of adult patients(n=147) at enrollment, 71.3% of patients achieved the target level of blood pressure. Triglyceride (TG), low-and high-density lipoprotein cholesterol (LDL-C and HDL-C) were 1.0(0.6,1.2), 1.6(1.3,1.8) and 2.8(2.1,3.2) mmol/l, with 88.4%, 85.4% and 43.8% achieving targets, respectively. After follow-up, the rate of target achievement in HDL-C increased to 92.9% (P=0.039). LDL-C level increased to 2.9(2.3,4.3) mmol/l (P=0.008), with body mass index (BMI) (20.3±2.3 to 21.2±2.2kg/m2, P<0.001) and insulin dosage (36.2(29,42) to 28.5(29.1,47.1)) units/day, P=0.01) increasing. Compared with the insufficient group, those achieving targets of HbA1c, lipids and blood pressure (20.1%) had more frequent self-monitored blood glucose (P=0.002) and lower BMI(P=0.025). The benefits of scheduled follow-up in glycemic control were sustained but not sufficient enough in the management of lipids in T1DM patients. Comprehensive management was needed to improve metabolic control. Disclosure Y. Zhou: None. J. Yan: None. D. Yang: None. S. Luo: None. X. Zheng: None. P. Ling: None. Z. Wu: None. Q. Huang: None. Y. Xian: None. C. Wang: None. Q. Lin: None. H. Liu: None. B. Yao: None. J. Weng: None. Funding Natural Science Foundation of Guangdong Province (2018A030313251); Science and Technology Planning Project of Guangzhou (201709010037)