Abstract 93: Ambulatory glucose profiles of children and adolescents with T1DM: Identification of factors affecting glycemic control

Abstract

Background: Continuous glucose monitoring (CGM) provides information about glycemic control, beyond that provided by HbA1c and SMBG, including short-term glycemic variability, hypoglycemic and hyperglycemic events.Aims and Objectives: To describe ATTD endorsed CGM derived glycemic variables from a cohort of T1DM, assess possible factors influencing glycemic control and study the association between HbA1c and these variables.Results: 61 patients (age, 15.9 + 5), median duration of diabetes 6 years, wore the FreeStyle libre for a median of 14 days. Mean TIR was 46.3 + 15.5, TBR 16.7 + 13.5 and TAR 36.9 + 22.0. Mean glycemic variability (%CV) was 48% and 90% had high %CV. Those using NPH had a significantly higher %CV (P=0.007) compared to those on glargine. Females (n=34, P=0.05) and those using NPH (n=18, P=0.08) tended to spend a longer time in hypoglycemia. HbA1c showed a negative correlation with TIR (r=-0.441), TBR (r=-0.544), %CV (r=-0.335) and a positive correlation with TAR (r=0.656), mean glucose (r=0.714). On subgroup analysis, group with lowest HbA1c (<6.8%, n=16), although had highest TIR but also highest TBR.Conclusion: Our findings demonstrate wide gaps between the recommended versus real world glycemic variables in children with T1DM and highlight the need to implement interventions for better glycemic control.Acknowledgements: This work was supported by a grant from the Endocrine Society of India.