ESPE Abstracts

Increased glycemic variability is an important risk factor in terms of complications independent of HbA1c. The aim of this study was; to investigate the relationship between continuous glucose monitoring system (CGMS) indices and clinical data, to investigate DNA damage in patients with diabetes and to evaluate the effect of glycemic variability on DNA damage. Fifty patients with T1DM, aged under 18 years old, who were followed up at least one year in Pediatric Endocrinology Department of Pamukkale University Faculty of Medicine and 21 healthy control objects were included in the study. “Medtronic iPro^TM2, Enlite Glucose Sensor®” was inserted and CGMS indices were calculated. Mean sensor glucose, standart deviation (SD), glucose management indicator (GMI), coefficient of variation (CV), time in range (TIR), time below range (TBR), time above range (TAR) indices were evaulated. Blood samples were taken for DNA damage, fasting lipids and HbA1c. Total 50 patients with a mean age of 13.69±2.99 (F/M: 30/20) were included to the study. Mean diabetes duration and HbA1c level were 4.39±2.39 years and 9.23±2.16%, respectively. Mean sensor glucose was 167.1±28.93mg/dl, TIR was 58.88±15%, TAR was 36.46±15.53%, TBR was 4,64±4,51%, SD was 64.64±15.22 mg/dl, CV was 39%, GMI was 7.45±1.01 %.The measured HbA1c value was higher than the GMI. There was a positive correlation between HbA1c and mean sensor glucose, GMI (r = 0.3, P = 0.03; r=0.29 P = 0.03). No relationship was found between HbA1c and other sensor indices. TBR and SD of the patients with stable glycemic variability (CV<36%) were lower than that of the unstable glycemic variability (≥36%). DNA damage parameters were similar between type 1 diabetes and healthy control groups. Tail length which is one of the parameter of DNA damage was higher in patients with poor metabolic control (HbA1c <7.5%) than that of the good metabolic control (HbA1c>7.5%). No significant difference was detected between stable and unstable glycemic variability groups regarding DNA damage parameters, however a positive correlation was found between the tail length, tail intensity and tail migration and % CV (P = 0.043, 0.034, 0.027).It was shown that DNA damage increased as glycemic variability increases. DNA damage of patients with poor metabolic control was higher than patients with good metabolic control.