ESPE Abstracts

Introduction: Recently, the impact of glycemic variability in the development of chronic complications of diabetes has been put in question. The gold-standard method to quantify glycemic variability is not well established.

Objective: To analyze the relationship between HbA1c and glycemic variability as determined from self-monitoring blood glucose (SMBG) in type 1 diabetes (T1D) pediatric population.

Patients/methods: Cross-sectional study in 175 T1D patients with a mean age of 12.2±4.2 years, 50% female. Variables analyzed were: age at diagnosis, time from diagnosis, and metabolic control (HbA1c, HPLC–Menarini, VN 5.31±0.31%). As parameters of glycemic variability we used: mean blood glucose (MG, mg/dl), S.D., percentage hypoglycaemia (<70 and <50 mg/dl) and hyperglycaemia (>180 mg/dl) during the last 1 and 3 months. As indices of glycemic variability: MG/2 relative to S.D. (adequate if MG/2 ≥S.D.) and J index (0.001×(MG+S.D.)²: ideal 10–20, adequate 20–30, and inadequate >40). Statistical analysis: SPSS, version 17.0 program.

Results: Mean age at diagnosis was 6.2±4.2 years, mean time TID duration 6.0±3.9 years and mean HbA1c 6.7±0.6%. Mean SMBG per day and patient 7.6±2.3. Mean capillary glycemia in last 3 months 150±70 mg/dl. The 61 and 63% of patients had a MG/2 ≧S.D. in last 1 and 3 months respectively. Patients with MG/2 ≧S.D. relation had significantly lower MG and S.D., hyper and hypoglycaemia percentage and HbA1c, with no differences in the number of daily capillary glycemic controls. Patients with inadequate J index had significant worse glycemic control. We found a positive correlation between HbA1c and MG, S.D., and J index.

Conclusion: The presence of inadequate glycemic variability is associated with worse glycemic and metabolic control in pediatric patients with T1D.