27-OR: Residual Beta-Cell Function Associates with Lower Glycaemic Variability and More Time in Range in Individuals with Type 1 Diabetes

Abstract

Introduction: A significant proportion of individuals with type 1 diabetes (T1D) have long-term preservation of beta-cell function. Residual beta-cell function (RBCF) is associated with fewer long-term complications and hypoglycemic events. Yet, little is known about the influence of RBCF on daily glycemic control. Therefore, we investigated the associations between RBCF and daily markers of glycemic control in individuals with T1D. Methods: In this cross-sectional study 500 individuals with T1D were included (41.0 ±14years), 64% female, HbA1c 55.6 ±12mmol/mol, median T1D duration 14 years [IQR: 6-29years]. As a validated marker of RBCF, postprandial urinary C-peptide/creatinine ratios (UCPCR) were measured. Time in euglycemic range (TIR) (3.9-10mmol/L) and hypoglycemic range (TUR) (<3.9-10mmol/L) were monitored 14 days prior to the study visit, with a continuous glucose monitoring device. Spearman correlations were calculated in Rstudio. Results: The median UCPCR was 0.03 (IQR: 0.00-0.88) nmol/mmol and strongly correlated with duration of T1D (r = -0.651, p < 0.001). Higher UCPCR correlated with longer TIR (r = 0.330, p < 0.001), lower mean glucose levels (r =-0.318, p=0.005) and shorter TUR (r= -0.237, p <0.001) and lower glucose variation (-0.356, p <0.001). In line, higher UCPCR associated with lower HbA1c levels (r= -0.183, p<0.001) and less 24-hour insulin use (r = -0.183, p = <0.001). The associations remained significant in linear regression models when adjusted for sex, age, plasma glucose and duration of diabetes. Conclusion: UCPCR correlates with more time in range, shorter time under range, and lower HbA1c levels in individuals with T1D. Beneficial effects of beta-cell preservation in T1D may therefore be attributable to less intermittent glucotoxicity and hypoglycaemic episodes. Disclosure C.Fuhri snethage: None. M.Nieuwdorp: Advisory Panel; caelus health. N.Hanssen: Consultant; Novo Nordisk, Research Support; Novo Nordisk. T.J.Mcdonald: None. E.Rampanelli: None. P.De groen: None. A.W.M.Schimmel: None. D.Van raalte: Consultant; Boehringer Ingelheim and Eli Lilly Alliance, AstraZeneca, Merck & Co., Inc., Research Support; Boehringer Ingelheim and Eli Lilly Alliance, AstraZeneca, Merck & Co., Inc. C.B.Brouwer: None. R.A.Oram: Consultant; Janssen Research & Development, LLC, Research Support; Randox R & D. B.O.Roep: None. Funding DNF DON Grant 2020 (2020.10.002)