400-P: High Levels of Glycemic Coefficient of Variation Are Associated with Higher Hypoglycemia Episodes in T1D Adults in a Brazilian Tertiary Hospital

Abstract

People with type 1 diabetes (T1D) have a higher risk of hypoglycemia (H), especially in the presence of high glycemic excursion, increasing cardiovascular mortality. The coefficient of variation (CV) allows current assessment of glycemic control and therapeutic adequacy. This cross-sectional study investigated the associations among H episodes, CV, glycemic variability (GV), and T1D clinical and laboratory parameters. Sixty T1D patients aged ≥18 years and followed for at least six months in a Brazilian Public Tertiary Hospital were included. Three seven-point glycemic profiles were performed in consecutive days, totalizing 21 blood glucose tests. The indicators GV, standard deviation (SD)/glycemic mean (mg/dL) and CV, SD/glycemic mean were calculated from data record in the monitor. H was classified as H1:<70 and ≥54mg/dL and H2:<54mg/dL. Statistical analysis was performed with Spearman correlation and Mann-Whitney (p<0.05 was considered significant). Of all, 73.3% were women, aged 34.7 ± 2.3 years, T1D duration: 22.5 ± 9.7 years, HbA1c 8.8 ± 1.8%, GV 70.9 ± 25.9mg/dL (goal<50) and CV 42.8 ± 9.6% (goal<36%). H occurred in 76.7%, and H2 in 50% of T1D patients. H1 was positively correlated with CV (p<0.0001) and T1D duration (p<0.0271); negatively with mean of glycemia (p<0.0001), and glycemia above target (>180mg/dL) (p<0.0004). H2 was positively correlated with CV (p<0.0005); blood glucose below target (<70mg/dL) (p<0.0001), and reported weekly frequency of hypoglycemia (p<0.0470). T1D patients presented high VC and GV. Only CV had a significant correlation with H1 and H2 episodes. Education about quickly hypoglycemia treatment is highly required, mainly in the presence of asymptomatic episodes. Systematic glycemic monitoring and continuing education in diabetes, targeting insulin dose adjustments, glycemic goals, healthy food orientation, and physical activity may reduce life risks of this population. Disclosure T.B. Brasil: None. A.C. Sposito: None. B. Adachi: None. W.M. Volpini: None. E.J. Pavin: None.