ESPE Abstracts

Background: In type 1 diabetes (T1D) adolescents it is necessary to design effective interventions to take care of their health and psychological problems. This leads to effective transition to an adult unit.

Objectives: Evaluate the relationship of lifestyle with metabolic control in diabetic adolescents.

Methods: Retrospective study of 42 T1D adolescents managed in a Pediatric Diabetes Unit. Patients completed a questionnaire on lifestyle and results were correlated to metabolic control.

Results: Patients included 20 males, 22 females with a mean age 15.8±1.6 years (13–18.49) and 7.3±3.4 years after diagnosis (1–14.62). Mean HbA1c 7.7±1%, 4.6±0.99 glycaemia/day, insulin dose 0.93 U insulin/kg per day and 4.2±1.22 injections/day. 90.5% received treatment with multiple doses of insulin (MDI). Comparing continuous subcutaneous insulin infusion (CSII) and MDI: number of injections/day: 4.07 MDI vs 6.8 CSII (P=0.01), insulin dose/day, HbA1c, blood glucose/day between groups was non significant. Number of boluses was significant negative correlated with HbA1c level (P=0.021); as well as number of glycaemia/day with HbA1c and blood glucose variability (p NS). Teens who exercise ≧3 times/week (64.3%) had better metabolic control than those who did not exercise (HbA1c 7.4% vs 8.3%; P=0.02). 9.5% of adolescents reported smoking and 38.1% reported drinking alcohol. Smoking (P=0.026) and drinking (P NS) were associated with poor metabolic control. 64.3% of adolescents always performed glycaemic check prior to insulin injections. 12.2% were seen by psychologists, and 75% of those would like to have a specific unit for adolescents with T1D. 64.95% of patients thought psychologist would help them and the worst controlled were the most demanding.

Conclusions: Exercising ≧3 times/week was associated with good metabolic control. Drinking alcohol, smoking, lower insulin injections and glucose determinations were associated with poor metabolic control. It exists a high demand, especially by those in poor control, to create specific units to provide psychological support.