THU105 PHH Parameters Are New Minimal-Invasive Markers Of Glycemic Homeostasis Of Type 1 Diabetes

Abstract

Abstract Disclosure: A. Harvengt: None. Aims: Recently, our team introduced the concept of post-hypoglycemic hyperglycemia(PHH) in the context that recovery of hypoglycemia impacts cardiovascular risk.GLUREDIA study aimed to evaluate whether PHH parameters correlated with glycemichomeostasis during the first year after type 1 diabetes onset and helped to distinguishpediatric patients undergoing partial remission or not. Methods: In the GLUREDIA study, longitudinal values of clinical parameters,continuous glucose monitoring metrics and residual beta-cell secretion from childrenwith new-onset type 1 diabetes were analyzed for one year. PHH is defined as anyhypoglycemia followed within two hours by hyperglycemia. PHH parameters werecalculated using an in-house built algorithm. Cross-sectional correlations betweenPHH parameters (i.e., PHH frequency, PHH duration, PHHAUC) and glycemichomeostasis markers were performed using adjusted mixed-effects models. Results: PHH parameters were strong markers to differentiate remitters from non-remitters (all p < 0.001), the most sensitive being PHH/Hyperglycemia duration ratio(cut-off < 0.02, sensibility: 86%, specificity: 68%). Among those, PHHAUC correlatedwith clinical parameters and continuous glucose monitoring metrics and inverselycorrelated with residual beta-cell secretion (all R2 > 0.22, p < 0.001). Furthermore,combination of PHH parameters identified three groups of patients that might benefitfrom distinct therapeutic management. Finally, patient classification into fourglucotypes, as previously described, independently validated PHH parameters asreliable markers of glycemic homeostasis and improved the segregation of patientswith intermediate values of IDAA1C and CPEPEST. Conclusion: PHH parameters are new minimal-invasive and easily assessed markersof partial remission and glycemic homeostasis during the first year of type 1 diabetesthat allow patient-specific therapeutic management. Presentation: