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FACTORS ASSOCIATED WITH LOWER GLYCEMIC VARIABILITY IN AN COHORT OF ADULTS WITH T1D ON CSII WITH PREDICTIVE LOW GLUCOSE SUSPEND (PLGS).

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Abstract

INTRODUCTION: Current paradigm of glycemic control considers lowering A1c with low glycemic variability (GV), in order to increase Time in Range. Our aim is to characterize a cohort of patients on CSII with PLGS and to identify factors associated with a lower GV. METHOD: Subjects on CSII with PLGS on follow-up ≥3 months at our clinic were included. Monthly pump downloads were recorded. Coefficient of Variation (CV) from sensor glucose was calculated from every download, and its association with number of daily SMBG, basal insulin percentage, daily basal segments, carbohydrate intake, hours of PLGS, days between set change and areas under the curve (AUC) <70 mg/dL and >140 mg/dL was explored. RESULTS: 72 subjects were included, aged 37 ±14 years, with disease duration of 18 ± 13 years. Most recent A1c was 6.98% ± 0.56%. 49% subjects were on insulin Aspart, 39% on Lispro and 12% on Glulisin. 401 downloads were analyzed. Low GV group, defined as CV ≤36%, had mean CV of 32.5%, compared to 39.9% on the High GV group (p<0.0001). Factors significantly associated with CV≤36% were the number of daily SMBG (6.7 vs. 6.1, p<0.0001), carbohydrate intake (173 vs. 187 grams, p=0.02), hours of PLGS (2.3 vs. 3.1 hours, p<0.0001), AUC<70 mg/dL (0.2 vs. 0.5, p<0.0001) and AUC>140 mg/dL (26.2 vs. 31.9, p<0.0001). CONCLUSIONS: T1D patients on CSII with PLGS with low GV have more daily SMBG, lower intake of carbohydrates, less hours of PLGS, lower AUC<70 mg/dL and lower AUC>140 mg/dL. These factors should be evaluated and incorporated in clinical decision making.

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© Copyright 2020 Morressier GmbH.
All rights reserved.