ESPE Abstracts

Achieving adequate glycaemic control in children with type 1 diabetes (T1D) is essential to reduce incidence and progression of microvascular and macrovascular complications. However, factors that influence glycaemic control remain to be understood. The present study aimed to evaluate clinical, personal, genetic and eating behaviour characteristics underlying glycaemic control in T1D. 325 T1D individuals aged 6 and 20 years and with at least 1 year of disease duration have been recruited in several paediatric diabetes centres. Personal, clinical and genetic data were collected. Standardized questionnaires on eating behaviour measures (food neophobia, food preferences, parental attitudes on child feeding) were administered. Glycaemic control was defined grouping participants based on HbA1c values as follow: Optimal Control (OC), HbA1c <7.5% (<58 mmol/mol); Intermediate Control (IC) HbA1c 7.5–8.5% (58–70 mmol/mol); Poor Control (PC), HbA1c > 8.5% (>70 mmol/mol). PC was significantly associated with higher duration of the disease (P-value=0.003), ketoacidosis at onset (P-value=0.008), greater value of standardized BMI (P-value=0.01) and total cholesterol level (P-value=0.01), pubertal status (P-value=0.04), lower parent education (P-value<0.001). Analysis of eating behaviour measures showed an increased level of food neophobia (“tendency to avoid eating new or unfamiliar foods”) in individuals with PC (P-value=0.01). Moreover, an association between parental practices, assessed by the Child Feeding Questionnaire, and glycaemic control emerged. Specifically, higher scores of “Restriction” (P-value<0.001), “Pressure to eat” (P-value<0.001) and “Concern about weight” (P-value=0.01) were observed in T1D individuals with poor control. Finally, preliminary genetic analysis on 176 individuals revealed that rs1800497 polymorphism in DRD2 gene is associated with HbA1c values (P-value=0.009); particularly, TT homozygous individuals showed higher values of HbA1c compared to heterozygous and homozygous for the alternative allele. This polymorphism has been related to several disorders in which neurotransmitter dopamine signaling is affected. Associations of rs1800497 with eating behaviour, glucose metabolism, body mass index and type 2 diabetes have been previously reported. This study, exploiting a comprehensive database of genetic, phenotypic and very deep clinical data, identified several factors, including eating behaviour characteristics, associated with glycaemic control in children and young adults withT1D. Identifying environmental and genetic factors predicting T1D glycaemic control could help to early recognize patients most at risk and establish specific controls or personalized therapeutic interventions.