Impact Of Glycemic Control Research Articles

Impact of Glycemic Control on Shoulder Proprioception in Type 2 Diabetes Mellitus: Mediating the Connection - Insights from a Cross-Sectional Analysis.

Shoulder proprioception is vital and this cross-sectional study investigated the association between glycemic control and shoulder joint proprioception in Type 2 Diabetes Mellitus (T2DM). A total of 120 participants, including 60 with T2DM and 60 healthy individuals, were assessed for shoulder joint position sense (JPS) using a digital inclinometer. The T2DM group exhibited significantly greater mean shoulder joint position errors in flexion (4.32° vs 2.15°), abduction, medial rotation, and lateral rotation compared to the healthy group (p < 0.001). The study found significantly greater shoulder joint position errors in the T2DM group compared to the healthy group, highlighting notable proprioceptive deficits in individuals with T2DM. Additionally, a significant positive correlation was found between HbA1c levels and shoulder joint position errors in the T2DM group, suggesting a link between long-term glycemic control and proprioceptive accuracy. The significant positive correlation between HbA1c levels and shoulder joint position errors suggests that poor glycemic control is associated with impaired proprioception in T2DM patients. This underscores the need for comprehensive management strategies to mitigate proprioceptive deficits and improve the quality of life in individuals with T2DM.

Event-Related Potential Changes Following 12-week Yoga Practice in T2DM Patients: A Randomized Controlled Trial.

Introduction. Type 2 diabetes patients are more likely to experience cognitive decline (1.5%) and dementia (1.6%) than healthy individuals. Although cognitive impairment adversely affects Type 2 diabetes mellitus (T2DM) patients, it is the least addressed complication of T2DM patients. Objective. The present study attempts to examine the changes in cognitive performance of T2DM patients and the probable factors contributing to the changes following 12-week yoga practice. Methods. The current study is a parallel group randomized controlled trial that compared the outcomes of the participants randomized to a yoga group (YG) (n = 25) and to a wait-list control group (n = 29). The study assessed N200 and N450 event-related potential (ERP) components following the Stroop task, heart rate variability (HRV) and HbA1c before and after the intervention. Results. The mean amplitude of the N200 ERP component showed a significant group difference after the intervention, demonstrating an improved neural efficiency in the process of conflict monitoring and response inhibition. No differences were present for the N450 component. T2DM patients showed reduced heart rate and increased mean RR following yoga practice without any corresponding changes in other HRV parameters, demonstrating an overall improvement in cardiac activity. Along with that yoga practice also reduced HbA1c levels in T2DM patients, indicating improved glycemic control. Moreover, HbA1c levels were negatively correlated with reaction time after the intervention, indicating an impact of glycemic control on cognitive performance. Conclusion. The 12-week yoga practice improved cognitive performance by enhancing the processes of conflict monitoring and response inhibition. Further, improved cognitive performance postintervention was facilitated by improved glycemic control.

Effects of prediabetes and type 2 diabetes on cognitive functions.

We aimed to investigate the effect of glycemic impairment in prediabetes on cognitive impairment and the impact of glycemic control on cognitive function in patients with diabetes. This age- and sex-matched case-control study included a total of 80 individuals: 20 patients with prediabetes, 20 patients with well-controlled type 2 diabetes mellitus (T2DM) (HbA1C < %7.5), 20 patients with poorly controlled T2DM (HbA1C >% 7.5), and 20 healthy controls. The poorly controlled T2DM patients performed significantly worse than controls and patients with prediabetes in the verbal memory process test (p = 0.041). In Trail Making Test B, the well-controlled and poorly-controlled groups with diabetes performed significantly worse (p = 0.015) than patients with prediabetes and controls, and in the Wisconsin Card Sorting Test (WCST), all three patient groups performed significantly worse (p = 0.007) than controls. T2DM causes early brain aging and declines cognitive functions since the prediabetic stage. Poor glycemic control in T2DM patients contributes to cognitive impairments, especially in learning.

Diabetes and Risk of Surgical Site Infection: A Narrative Review

Background: Diabetes Mellitus (DM) significantly elevates the risk of surgical site infections (SSIs), a major postoperative complication that increases morbidity, prolongs hospital stay, and escalates healthcare costs. The complex interplay between hyperglycemia-induced immunosuppression, impaired wound healing, and the increased propensity for infections in diabetic patients underscores the need for a comprehensive understanding of the mechanisms at play and effective management strategies. Objective: This narrative review aims to synthesize current evidence on the relationship between DM and the risk of SSIs, emphasizing the pathophysiological mechanisms, the impact of glycemic control on surgical outcomes, and the role of advanced surgical techniques in mitigating this risk. Methods: A systematic literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar for studies published up to April 2023, using keywords related to DM, SSIs, and perioperative management. Inclusion criteria targeted studies on the association between DM and SSIs, focusing on outcomes in diabetic versus non-diabetic patients, and the effectiveness of glycemic control. Data extraction and synthesis were performed using a narrative approach, with quality assessment based on study design-specific appraisal tools. Results: The review highlights that diabetic patients exhibit a significantly higher risk of developing SSIs compared to non-diabetic individuals, attributed to impaired immune response, microvascular complications, and delayed wound healing associated with hyperglycemia. Effective preoperative and postoperative glycemic control, maintaining hemoglobin A1c (HbA1c) levels below 7%, has been shown to reduce the incidence of SSIs. Furthermore, advancements in minimally invasive surgical techniques have contributed to lower SSI rates by reducing tissue trauma and preserving immune function. Conclusion: Diabetes mellitus is a significant risk factor for surgical site infections, underscoring the importance of stringent glycemic control and the adoption of advanced surgical techniques in the perioperative management of diabetic patients. Future research should focus on refining glycemic control strategies, understanding the genetic and molecular mechanisms underlying increased SSI risk, and developing targeted therapies to improve surgical outcomes in this high-risk population.

The Impact of Glycemic Control on Sodium-Glucose Co-Transporter 2 Inhibitor-Associated Genitourinary Infections.

Patients with type 2 diabetes (T2D) are at an increased risk of genital urinary (GU) infections, with the risk increasing with higher A1Cs. Given the broad adoption of sodium-glucose co-transporter 2 inhibitors (SGLT2is) in patients with T2D, both providers and patients need to be aware of common adverse effects associated with these medications, specifically GU infections. However trials involving SGLT2is looked at patients with an average A1C of less than 9%, and thus, the incidence of GU infections may not truly reflect the general diabetic population. The purpose of this study is to assess the association between GU infections in patients started on SGLT2is and A1C levels. A retrospective study was conducted on patients seen in an adult, primary care clinic, at New York City Health and Hospitals, South Brooklyn Health. Men and nonpregnant, nonlactating women >18 years old with a diagnosis of T2D who were initiated on an SGLT2i between January 2018 and January 2023 were included in the analysis. The primary endpoint is to compare the risk of GU infections in patients with T2D who were started on SGLT2is, regardless of dose, with hemoglobin A1C of >9% to those with hemoglobin A1C <9% at baseline. Three hundred and twenty-eight patients were eligible based on specified inclusion and exclusion criteria. Overall, there was a statistically significant difference in the number of GU infections that occurred in patients with a baseline A1C >9% compared with those with an A1C <9% (95% confidence interval [CI] = 1.05-2.88; P = 0.041). Type 2 diabetes patients initiated on SGLT2is may experience an increased risk of GU infection, especially in those patients with an A1C of 9% or greater. Further research is necessary to validate and expand upon these findings.

Perioperative glycemic control reduces the risk of retear in diabetic patients following arthroscopic rotator cuff repair: A meta-analysis

BackgroundPrevious studies have associated diabetes with reduced shoulder motion, increased pain, and higher postoperative retear risk after arthroscopic rotator cuff repair (ARCR). However, the impact of glycemic control, measured by hemoglobin A1c (HbA1c) levels, on retear and revision rates after ARCR in diabetic patients remains unclear. MethodsThis systematic review was conducted using the PubMed, Cochrane Library, Web of Science, and Embase databases according to the preferred reporting conventions for systematic reviews and meta-analyses. Only studies that compared retears and revisions in ARCR patients with documented HbA1c levels between controlled and uncontrolled diabetes groups were included. Relevant data were extracted and analyzed using STATA software. The methodological index for nonrandomized studies was employed to assess the risk of bias in the selected studies. Additionally, heterogeneity tests and sensitivity analyses were conducted to evaluate potential heterogeneity within the samples, and publication bias was also detected. ResultsSix studies (4395 patients), including five retrospective cohort studies and one case‒control study, were included. Four of these studies assessed retears involving 253 patients. Lower HbA1c levels, indicating better glycemic control, were significantly associated with reduced retear rates after ARCR in diabetic patients (P = 0.000; odds ratio = 0.242, 95 % confidence interval: 0.128–0.454; I2 = 25 %). For revision evaluations, two studies, with a total of 4142 patients, found no significant difference in rates between controlled and uncontrolled diabetes groups, and no publication bias was detected. ConclusionFollowing ARCR in diabetic patients, effective glycemic control significantly reduces retear rates without affecting revisions, and maintaining glycemic control in the postoperative period may contribute to rotator cuff healing.

Impact of Glycemic Control on Ischemic Stroke Severity and Outcomes: A Prospective Single Centre Study

Impact of Glycemic Control on Ischemic Stroke Severity and Outcomes: A Prospective Single Centre Study

Impact of Glycemic Control on Technique Failure in Incident Peritoneal Dialysis with Diabetes: Focusing on Volume Overload

Impact of Glycemic Control on Technique Failure in Incident Peritoneal Dialysis with Diabetes: Focusing on Volume Overload

The Impact of glycaemic control in Type 2 Diabetes Mellitus patients on left ventricular diastolic function: Two-Dimensional Echocardiography Based Study.

the Impact of glycaemic control in Type 2 Diabetes Mellitus patients on left ventricular diastolic function: Two-Dimensional Echocardiography Based Study.

Impact of Glycemic Control on Coronary Inflammation Evaluated by Computed Tomography Pericoronary Fat Attenuation Index in Patients with Acute Coronary Syndrome.

Coronary inflammation causes significantly increased risk of cardiovascular disease (CVD) in diabetic patients. This study investigated the relationship between coronary local inflammation, detected by pericoronary fat attenuation index (FAI), and different blood glucose control levels in low-risk acute coronary syndrome (ACS) patients with or without diabetes. A total of 309 patients with low-risk ACS were classified into three groups: non-diabetes, well-regulated diabetes, and poorly regulated diabetes. Pericoronary FAI around the proximal or left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA), were evaluated by coronary computed tomography angiography (CCTA), and systemic inflammatory variables and other biochemical indicators were detected by flow cytometry. Pericoronary FAI values around the proximal LAD, LCX, and RCA in poorly regulated diabetes were significantly higher than those in well-regulated diabetes and non-diabetes, whereas those in well-regulated diabetes were not statistically different from those in non-diabetes. Further, plasma glycated hemoglobin (HbA1c) level was positively correlated with the pericoronary FAI values in LAD, LCX, and RCA. However, no significantly increased systemic inflammatory mediators were found in diabetic patients with poor glycemic control. Diabetic patients with poor glycemic control may have higher coronary local inflammation as detected by pericoronary FAI surrounding the three major coronary arteries. NCT05590858.

THU-438 - The impact of glycemic control on progressive forms of non-alcoholic fatty liver disease: combined data from multiple clinical trials including more than 5000 patients (in collaboration with NAIL-NIT consortium)

THU-438 - The impact of glycemic control on progressive forms of non-alcoholic fatty liver disease: combined data from multiple clinical trials including more than 5000 patients (in collaboration with NAIL-NIT consortium)

Glycemic control and the risk of tuberculosis in patients with diabetes: A cohort study in a Mediterranean city.

Diabetes mellitus (DM) is one of the leading chronic diseases globally and one of the most common causes of death, morbidity, and poor quality of life. According to the WHO, DM is also one of the main risk factors for developing active tuberculosis (TB). Subjects with DM are at a higher risk of infections, in addition to frequent micro and macrovascular complications, and therefore sought to determine whether poor glycemic control is linked to a higher risk of developing TB. We used a retrospective cohort of diabetic subjects to predict the incidence of TB. All DM patients were recruited from Ciutat Vella (the inner-city of Barcelona) from January 2007 until December 2016, with a follow-up period until December 2018 (≥2 years). Data were extracted from Barcelona's Primary Care medical record database - SIDIAP, and linked to the Barcelona TB Control Program. The incidence of TB and the impact of glycemic control were estimated using time-to-event curves analyzed by Cox proportional hazard regression. Hazard ratios (HRs) and 95% confidence intervals (CIs), unadjusted and adjusted by potential confounding variables, were also assessed, which included age, sex, diabetes duration, macrovascular and microvascular signs, BMI, smoking habit, alcohol consumption and geographical origin. Of 8,004 DM patients considered for the study (equating to 68,605 person-years of follow-up), 84 developed TB [incidence rate = 70 (95% CI: 52-93) per 100,000 person-years]. DM subjects with TB were younger (mean: 52.2 vs. 57.7 years old), had higher values of glycosylated hemoglobin (HbA1c) (7.66 vs. 7.41%) and total triglycerides (122 vs. 105 mg/dl), and had twice the frequency of diabetic nephropathy (2.08 vs. 1.18%). The calculated incidence rate increased with increasing HbA1c: 120.5 (95% CI 77.2-179.3) for HbA1c ≥ 7.5%, 143 (95% CI 88.3-218.1) for HbA1c ≥ 8% and 183.8 (95% CI 105-298) for HbA1c ≥ 9%. An increase in the risk of TB was also observed according to a poorer optimization of glycemic control: adjusted HR 1.80 (95% CI 0.60-5.42), 2.06 (95% CI 0.67-6.32), and 2.82 (95% CI 0.88-9.06), respectively. Diabetic subjects with worse glycemic control show a trend toward a higher risk of developing TB.

The Impact of Glycemic Control in Thrombo-Inflammatory Biomarkers in Diabetic Pulmonary Embolism Patients

The Impact of Glycemic Control in Thrombo-inflammatory Biomarkers in Diabetic Pulmonary Embolism Patients. Bulent Kantarcioglu, Alexander O'Hara, Jacob Pozin, Roumika Patil, Maddie Allen, Emily Krupa, Fakiha Siddiqui, Debra Hoppensteadt, Atul Laddu, Amir Darki, Jawed Fareed. Introduction: Venous thromboembolism (VTE) is estimated to affect between 350,000-600,000 individuals annually in the United States. The mortality rate is approximately 100,000 people each year. Diabetes mellitus (DM) is one of the most common metabolic disorders resulting from dysregulated glucose metabolism and is a very important risk factor for cardiovascular disease. Several different factors contribute to thrombotic events in DM; these include inflammatory states, primary hemostatic changes, increased levels of various clotting factors, impaired fibrinolysis, increased oxidative stress, and endothelial dysfunction. However, the results of previous studies were inconsistent to explain the complex relationship between the poor glycemic control in DM and development of PE. HbA1c, which is used as an indicator for glycemic control, may also be an important measurement to quantify the level of thromboinflammatory response that is observed in diabetic patients. Thrombo-inflammatory biomarkers such as D-Dimer, CRP, PAI-1, tPA, TAFI, vWF and endogenous glycosaminoglycans (GAGs) were investigated in several previous studies, however, the relevance of these biomarkers in complex relationships of DM and PE is not completely understood. This study aimed to investigate the role of DM in modulating thromboinflammatory biomarkers in PE patient. Materials & Methods: The diabetic PE patient samples were collected following the ongoing IRB and PERT protocols at Loyola University Medical Center and affiliated hospitals. The levels of thrombo-inflammatory markers (D-Dimer, CRP, PAI-1, tPA, TAFI and vWF) were tested by ELISA methods, endogenous GAGs with heparin red (Red Probes, Muenster, Germany) method. The clinical information of 113 diabetic PE patients, including the HbA1c levels within 3 months of PE diagnosis were collected through chart review of the electronically medical records of the patients. After exclusion of patients with active cancer, circulating levels of each biomarker in diabetic PE patient plasma (n:90) were compared to healthy controls (n:30) and according to HbA1c levels (n:45). Results: The levels of all the tested biomarkers were elevated in diabetic PE patients in comparison to healthy controls (P< 0.05). D-dimer (25.06-fold) and CRP (42.01-fold) have shown the most prominent increases in comparison to healthy controls (Table 1). We did not observe any significant difference in the levels of D-dimer, CRP, PAI-1, t-PA and endogenous GAGs according to HbA1c levels (p< 0.05). The levels of TAFIa (p<0.01) and vWF (p: 0.03) were significantly higher in diabetic patients that had a HbA1c ≥ 7. Conclusion: Our findings support that the increased levels of thromboinflammatory biomarkers and dysregulation of hemostatic pathways are important pathophysiological mechanisms in diabetic PE patients. Increased levels of TAFI and vWF may be the potential contributors of impaired fibrinolysis and endothelial dysregulation in diabetic PE patients who have poor glycemic control. These results underscore the importance of glycemic regulation in diabetic PE patients. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

RF28 | PSUN185 The effects of diabetes and glycemic control on cancer outcomes in individuals with metastatic breast cancer

Abstract Background While a well-established relationship between diabetes and breast cancer exists, it remains unclear how diabetes impacts breast cancer outcomes. This study aims to determine the impact/association of diabetes and hyperglycemia on cancer progression and mortality in individuals with metastatic breast cancer. Methods Patients with metastatic breast cancer between 2010-2021 were identified using the metastatic breast cancer database at a single academic center. The Research Patient Data Registry, a data warehouse of all patients receiving care in the hospital network was then used to determine the diabetes status of each participant. A participant was categorized as having diabetes if they fulfilled pre-specified criteria (international classification of diseases (ICD) 9 or 10 code for diabetes, or a hemaglobin A1c ≥6.5%, or a random blood glucose (RBG) ≥200 mg/dL and documented use of glucose-lowering agents), while controls were defined as individuals who did not fulfill the previous criteria. We evaluated the effects of diabetes on 1) overall survival (OS) and 2) the interval from initiation of first-line metastatic therapy to initiation of a second-line regimen due to documented progression of disease (a surrogate measure of progression-free survival). The impact of glycemic control on OS and duration of first-line therapy was also assessed. Results We compared 244 patients with diabetes (median age 57.6 years) to 244 patients without diabetes, who were matched for age, gender, ethnicity and hormone-receptor (HR) status. OS at 5 years (diabetes: 54%, CI; 47-62% vs. controls: 56%, CI; 49-63%, p=0.65) and freedom from initiating a second-line regimen at 2 years (diabetes: 43%, CI; 36-50% vs. controls: 44%, CI; 36-51%, p=0.33) were not statistically different between groups. However, in an 8-year landmark subgroup analysis, OS was better amongst controls than those with diabetes (diabetes [n=27]: 67%, CI; 48-86% vs. Controls [n=28]: 87%, CI; 73-100%, p=0.047at 10 years). Poor glycemic control (median RBG &amp;gt;180 mg/dL or median HbA1c &amp;gt;7%) was not associated with increased mortality at 5 years but was associated with a trend towards worse freedom from initiating a second-line regimen at 2 years when compared to good glycemic control. In a sub-group analysis based on HR status, there were no differences in OS at 5 years, or freedom from initiating a second-line regimen at 2 years between the two glycemic groups (≤180 mg/dL vs &amp;gt;180 mg/dL on two or more occasions in a month) for any of the HR subgroups. Conclusions These data provide some reassurance that hyperglycemia may not be a major contributor to overall mortality in the first 5 years, in most individuals with metastatic breast cancer. However, amongst longer-term survivors, diabetes was associated with worse survival, suggesting that individualized diabetes and glycemic goals should, therefore, be considered in patients with metastatic breast cancer. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m., Monday, June 13, 2022 12:51 p.m. - 12:56 p.m.

The Impact of Glycemic Control on Procalcitonin Level in Patients with Type II Diabetes

Background: Diabetes mellitus is a chronic condition characterized by hyperglycemia that can lead to serious complications. It results from a defect in insulin secretion, insulin resistance, or both. Type 2 diabetes mellitus (T2DM) is the most common type of diabetes and mainly affects adults. It is associated with insulin resistance and low-grade chronic inflammation in the adipose tissue, muscles, and liver. Measurement of hemoglobin A1c (HbA1c) is one of the most widely used tests to monitor diabetes. The aim of this study was to shed light on the effect of glycemic control of type 2 diabetes on procalcitonin (PT) levels in order to prevent future complications. Materials and Methods: This case-control study included 68 patients with type 2 diabetes mellitus. At Biochemistry Department, College of Medicine, and University of Baghdad and at Al-Sadiq Teaching Hospital in Al-Hilla City, during the period from July 2020 to October 2020. Hemoglobin A1C (HbA1c) was estimated by using an affinity chromatography assay. These patients were divided according to HbA1c level into bad control group (HbA1c &gt; = 7%) which included 36 patients, and good control group (HbA1c &lt;7%) which included 32 patients. Another group of 32 nondiabetic apparently healthy subjects (HbA1c &lt;5.7%) served as control group. Patients with type 1 diabetes mellitus (T1DM), gestational diabetes, insulin-treated type 2 diabetes, history of recent infection, diabetic foot, ischemic heart disease, cerebrovascular disease, or recent trauma or surgery were excluded. PCT of each participant was estimated using an enzyme-linked immunosorbent assay (ELISA). Results: The mean PCT values of bad control group, good control group, and control groups were 871.3776, 834.5005, and 208.5313 pg/mL, respectively. The study showed that there was no significant difference in mean PCT between good control and bad control groups (P &gt; 0.05). In addition, there was no significant correlation between PCT and HbA1c among diabetic patients (r = 0.072, P &gt; 0.05). However, there is a significant differences in mean of PCT values between diabetic patients and control group (P &lt; 0.05). Conclusion: There was no effect of glycemic control on PCT level in patients with T2DM. However, the level of PCT was increased in comparison with non-diabetic healthy subjects.

Differential impact of glycemic control and comorbid conditions on the neurophysiology underlying task switching in older adults with type 2 diabetes.

Type 2 diabetes is known to negatively affect higher order cognition and the brain, but the underlying mechanisms are not fully understood. In particular, glycemic control and common comorbidities are both thought to contribute to alterations in cortical neurophysiology in type 2 diabetes, but their specific impact remains unknown. The current study probed the dynamics underlying cognitive control in older participants with type 2 diabetes, with and without additional comorbid conditions (i.e., cardiovascular disease, nephropathy, peripheral neuropathy, retinopathy), using a task switching paradigm and a dynamic functional brain mapping method based on magnetoencephalography (MEG). We hypothesized that neural dynamics would be differentially impacted by the level of glycemic control (i.e., diabetes itself) and the burden of additional comorbid conditions. Supporting this hypothesis, our findings indicated separable, but widespread alterations across frontal, parietal, temporal and cerebellum regions in neural task-switch costs in type 2 diabetes that were differentially attributable to glycemic control and the presence of comorbid conditions. These effects were spatially non-overlapping and the effects were not statistically related to one another. Further, several of the effects that were related to the presence of comorbidities were associated with behavioral performance, indicating progressive deficits in brain function with extended disease. These findings provide insight on the underlying neuropathology and may inform future treatment plans to curtail the neural impact of type 2 diabetes.

471-P: Glycated Haemoglobin in the First Year after Diagnosis of Type 1 Diabetes Is an Independent Risk Factor for Diabetic Retinopathy: The IMDIAB 25 Years Follow-Up Study

Background: Intensive glycemic control reduces the risk of diabetic retinopathy (DR) in people with type 1 diabetes (T1D) . However, the impact of glycemic control during the peri-diagnostic period on the long-term risk of DR is not known.Aim: To evaluate the association between the glycemic control obtained within the first year after T1D diagnosis and the long-term risk of DR. Methods: We retrospectively studied a cohort of 150 subjects enrolled within 1 year of T1D diagnosis in intervention trials conducted by the IMmunotherapy DIABetes (IMDIAB) group between 1994 and 20 and still attending follow-up visits in one of the IMDIAB centers. Data regarding clinical and biochemical features at T1D onset and during the first year of the disease were collected at the time of enrollment in the IMDIAB studies. Follow-up data about clinical features including presence of chronic complications were collected between January 2020 and January 2021 through the consultation of medical records. Results: After a median follow-up of 25 [25th-75th percentiles: 22-28] years, 26 (17.3%) people had developed DR. People with DR showed significantly higher updated first-year HbA1c (6.8 [6.2-7.8] % vs. 6.3 [5.7-7.2] %, p=0.037) and higher HbA1c at follow-up (8.0 [6.9-8.9]% vs. 7.2 [6.5-7.8]%, p=0.005) compared to people free from DR. Higher updated first-year HbA1c was also a significant predictor of higher HbA1c at follow-up (beta-coefficient: 0.24, p=0.015) . The association between the updated first-year HbA1c and DR did not significantly change after adding HbA1c at follow-up and disease duration in the multivariate model. Conclusion: Glycemic control obtained during the very first year after T1D onset is associated with long-term risk of diabetic retinopathy independently from subsequent glycemic control and other confounders. Disclosure E.Maddaloni: Consultant; Merck KGaA, Speaker's Bureau; Abbott, Medical Technology &amp; Devices, PIKDARE S.p.A. C.Moretti: None. N.Visalli: Consultant; Sanofi. F.Tramontana: None. A.Crino: None. R.Schiaffini: Advisory Panel; Abbott, Sanofi. R.Buzzetti: Board Member; Lilly, Novo Nordisk, Sanofi, Speaker's Bureau; Abbott, AstraZeneca. P.Pozzilli: Advisory Panel; Dompé, Consultant; Abbott, Speaker's Bureau; Dompé, Lilly Diabetes, Medtronic, Sanofi. Imdiab study group: n/a. A.Carlone: None. D.Pitocco: None. G.Leanza: None. C.Suraci: None. M.Altomare: None. M.G.Cavallo: Advisory Panel; Eli Lilly and Company, Board Member; Novo Nordisk, Speaker's Bureau; AstraZeneca, Sanofi. I.Barchetta: None. S.Morano: None. Funding Italian Ministry of University and Research (PRIN 2017: 20175L9H7H)

Type 1 diabetes on continuous subcutaneous insulin infusion: impact of glycaemic control on quality of life

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Analysis of clinical features of patients with type 2 diabetes mellitus with different levels of glomerular filtration rate

Aim to improve the dispensary follow-up of patients with type 2 diabetes (DM) by identifying clinical signs, available during examination in the outpatient clinic, that suggest the development of chronic kidney disease (CKD).&#x0D; Material and methods. A cross-sectional study included a population sample of patients with type 2 diabetes and focused on the clinical indices available during an outpatient consultation. 150 protocols of outpatient consultations were selected using the compliance criteria, including data on 72 clinical indices. The general sample was divided into groups in two ways: by the level of glomerular filtration rate (GFR) and by achieving the goals of glycemic control (calculated parameter delta HbA1c).&#x0D; Results. The following indices differed most significantly in the groups divided by stages of CKD: gender, age, duration of diabetes and insulin therapy, achievement of target values of glycemic control, blood pressure level, comorbid cardiovascular pathology, pulse on the popliteal artery. In patients with preserved GFR and the early stages of CKD, the fact of unsatisfactory glycemic control was associated with an increase in plasma creatinine and a decrease in GFR, higher blood pressure values. In the advanced stages of CKD, the impact of glycemic control on kidney function was practically absent.

Association between glycemic control and risk of venous thromboembolism in diabetic patients: a nested case\u2013control study

BackgroundPrevious studies suggested an elevated risk of venous thromboembolism (VTE) among patients with type 2 diabetes mellitus (T2DM), with a possible sex difference. The impact of glycemic control on the risk of VTE is unclear. Our objective was to analyze the association between glycemic control and the risk of unprovoked (idiopathic) VTE in men and women with T2DM.MethodsWe conducted a nested case–control analysis (1:4 matching) within a cohort of patients with incident T2DM between 1995 and 2019 using data from the CPRD GOLD. We excluded patients with known risk factors for VTE prior to onset of DM. Cases were T2DM patients with an unprovoked treated VTE. The exposure of interest was glycemic control measured as HbA1c levels. We conducted conditional logistic regression analyses adjusted for several confounders.ResultsWe identified 2′653 VTE cases and 10′612 controls (53.1% females). We found no association between the HbA1c level and the risk of VTE in our analyses. However, when the most recent HbA1c value was recorded within 90 days before the index date, women with HbA1c levels > 7.0% had a 36–55% increased relative risk of VTE when compared to women with HbA1c > 6.5–7.0%.ConclusionsOur study raises the possibility that female T2DM patients with HbA1c levels > 7% may have a slightly higher risk for unprovoked VTE compared to women with HbA1c levels > 6.5–7.0%. This increase may not be causal and may reflect differences in life style or other characteristics. We observed no effect of glycemic control on the risk of VTE in men.