E-POSTER VIEWING (EXHIBITION HOURS)
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Channel
E-Poster Area
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Session Description
PLEASE NOTE: E-POSTER VIEWING IS DURING THE EXHIBITION HOURS OF EACH DAY.

ASSOCIATION OF ADIPONECTIN POLYMORPHISM WITH ADIPONECTIN LEVELS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS WHO HAVE BEEN TAKING METFORMIN AND INSULIN FOR A LONG TIME.

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:30 - 09:31
Presenter
  • Ziba G. Ahmadova, Azerbaijan
Authors
  • Ziba G. Ahmadova, Azerbaijan
  • Sabina Orujova, Azerbaijan
  • Aisha Musayeva, Azerbaijan

Abstract

Background and Aims

The purpose is to examine the adiponectin polymorphism ADIPQQ-g93054571A > G and its association with adiponectin concentration in the serum, to research the effect of sugar-lowering therapy on adiponectin levels.

Methods

58 patients with type 2 DM were examined, 28 used metformin, 30 used insulin.

The average age at the time of the survey was 56.65 ± 1.51 years. Disease duration averaged 5.8 ± 3.5 years.

The serum concentration of adiponectin was determined by ELISA (Germany) using the Mediagnost E09 Adiponectin test kit. Insulin resistance was calculated with HOMA-IR index; glycated hemoglobin (HbA1).

The polymorphism of adiponektin (ADIPQQ-g93054571 A > G) was conducted by the method of using MALDI-TOF mass spectrometer company Sequenom (USA).

Results

The average value of glycosylated hemoglobin amounted to

8.66 ± 2.2%. Adiponectin median was 11.78 ± 4.32 mg / ml in patients taking metformin, and -3.52 ± 2.02 mg / ml in patients taking insulin. HOMA-IR on metformin was 5.15-3.32 μg / ml, on insulin it was 17.23 ± 9.78 μg / ml

According to our data, the ratio of Adiponectin / Homa (A / H) on the background of therapy with Metformin was 2.29 , while with insulin it was 0.204.

Conclusions

The results confirm the need to include metformin in the treatment complex of patients with type 2 DM to increase adiponectin level. In patients taking metformin adiponectin content is significantly increased compared with the figure for insulin therapy, this is 3.35 times (p <0.01).

Metformin eliminates the phenomenon of “hyperglycemic memory”, normilizes weight and lipid metabolism.

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ASSESSMENT OF LIPID ABNORMALITIES AND CARDIOVASCULAR RISK INDICES IN TYPE 2DIABETES MELLITUS

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:31 - 09:32
Presenter
  • Sushil Baral, Nepal
Authors
  • Sushil Baral, Nepal

Abstract

Background and Aims

NTRODUCTION
Incidence of cardiovascular events is increased more among diabetic patients. Dyslipidemia in diabetes is characterized by elevated triglyceride (TG), low (HDL-C) and increased prevalence of small dense low density lipoprotein cholesterol (LDL-C) particles. Serum total cholesterol (TC) and LDL-C have been used as major laboratory measures in clinical practice to assess cardiovascular risk. Recent studies,have shown that Non HDLc is like or better than LDL-C alone in the prediction of cardoivascular risk. the aim of this study is to assess the lipid abnormalities with cardiovascular risk using atherogenic coefficient,Cardiac Risk Ratio (TC/HDLc and LDLc/HDLc), TG/HDLc and Non- HDL

Methods

A cross-sectional descriptive study conducted at Bir hospital (tertiary care center) Nepal. Patients diagnosed as diabetes with age 30 years or above were selected in this study during a period of 1 yr.

Results

The mean age of the patients enrolled was 55.08±1.11 (34-81) year with male (52 %) to female (48%) ratio is 1.08:1. In this study the mean Non HDLc was 165.24±43.40 mg/dl (65-323).This study show the strong correlation of Non HDLc with total cholesterol(r=.990,p=0.000),LDLc(r=.602,p=0.000),TG(r=.411,p=0.000),LDLc/HDLc(r=.580,p=0.000),TC/HDLc((r=.866,p=0.000),TG/HDLc(r=.390 ,p=0.000). The mean AC in our study was 4.0±1.09. The finding was slightly higher is female compare to male i.e mean ±S.D 4.07±1.31 and 3.94±1.15.

Conclusions

The association between abnormal lipid levels and cardiovascular risk is evident among patients with diabetes mellitus. In this study there is the correlation with FBS, Non HDL-c cholesterol, Cardio risk ratio, TG/HDLc, Atherogenic coefficient. Hence Non-HDL cholesterol and Atherogenic indices proves to be more sensitive and a better predictor of cardiovascular events.

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THE FOCUS ON THE PROFESSIONAL GLUCOCARDIOMONITORING AT THE PATIENTS WITH TYPE 2 DIABETES MELLITUS

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:33 - 09:34
Presenter
  • Natalia Chernikova, Russian Federation
Authors
  • Natalia Chernikova, Russian Federation
  • Ludmila Kamynina, Russian Federation
  • Alexander S. Ametov, Russian Federation

Abstract

Background and Aims

The main reason for the complications of Type 2 Diabetes Mellitus (T2DM) and T2DM-death is cardiovascular. The high glycemic variability (GV) influences on the cardiac dysfunction. The continuous glucose monitoring (CGM) becomes the available clinical component. The aim is to establish the quantitative interplay between the glycemic CGM-GV and the Holter monitoring (HM) parameters at T2DM

Methods

In the observational study 454 patients with T2DM were included. During 5 days Professional CGM using iPro2 and HM synchronically were performed. The data were treated with Statistica19.0.

Results

We determined that the Ventricular arrhythmias (VAs) were associated with high GV and hyperglycemia. The Pearson correlation coefficients (σ) between VAs and SGM-parameters were 1,0 with Time in hyperglycemia (TIR-HYPER), -0,615 - Time in normoglycemia (TIR-NORMO), 0,104 - Time in hypoglycemia (TIR-HYPO), 0,006 - Minimal glycemia level (MinGl), 0,591 - Maximal glycemia level (MaxGl), 0,467 - Average glycemia level (AvGl), 0,727 - Glycemic Fluctuations >4 mmol/L/hr (GF>4), 0,564 - Standard deviation (SD). Also σ between Depression ST and SGM-parameters were 0,102 (TIR-HYPER), -0,181 (TIR-NORMO), 0,394 (TIR-HYPO), -0,136 (MinGl), 0,098 (MaxGl), 0,062 (AvGl), 0,158 (GF>4), 0,121 (SD). The prolongation of the QTc interval is maximally correlated with TIR-HYPO (σ=0,333).

Conclusions

The glucocardiomonitoring is the valuable clinical instrument for the early detection of T2DM-patients with high GV and high cardiological risk and the further optimization of T2DM-management

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PROFESSIONAL MONITORING FOR TYPE 2 DIABETES MELLITUS: CONTRIBUTION TO GLYCEMIC VARIABILITY FROM RELIGIOUS FASTING

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:34 - 09:35
Presenter
  • Natalia Chernikova, Russian Federation
Authors
  • Natalia Chernikova, Russian Federation
  • Ludmila Kamynina, Russian Federation
  • Alexander S. Ametov, Russian Federation

Abstract

Background and Aims

The minimizing of the glycemic variability (GV) is the priority task at Type 2 Diabetes Mellitus (T2DM) management. The religious fasting (RF) is the period when the differences in food, drugs and schedule take place. Aim: to investigate GV using the continuous glucose monitoring (CGM) at the patients with T2DM at RF and without RF to determine the GV-CGM-characteristics associated with RF

Methods

110 patients with T2DM took part in CGM using iPro2 (5 days). We assessed the differences in the GV-CGM-parameters at RF (n=55) and without RF (n=55). The data array was treated with Statistica19.0, the distinctions were significant if p<0,05

Results

The main CGM-parameters at and without RF were the following (medians): 34 and 22% Time in hyperglycemia (TIR-HYPER), p<0,05; 66 and 76% Time in normoglycemia (TIR-NORMO), p>0,05; 0 and 2% Time in hypoglycemia, p>0,05; 4,6 and 4,2 mmol/L Minimal glycemia, p>0,05; 12,1 and 9,2 mmol/L Maximal glycemia (MaxGl), p<0,05; 8,9 and 7,9 mmol/L Average glycemia (AvGl), p<0,05; 2,4 and 1,3 Glycemic Fluctuations >4 mmol/L (GF>4), p<0,05; 2,4 and 1,4 Standard deviation (SD) mmol/L, p<0,05. The coefficient variation CV was 28,5±4,3 and 18,9±2,1%, p<0,05

Conclusions

The postprandial hyperglycemia is the main factor influenced on the GV-raising (increase MaxGl, AvGl, TIR-HYPER, SD, FG>4, CV; decrease TIR-NORMO), if the endocrinological safety rules for RF don’t carry out. Professional CGM during RF is necessary in real-life clinical practice

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USE OFF-LABEL CONTINUOUS GLUCOSE MONITORING (CGM), NOT REQUIRING FINGERSTICK CALIBRATIONS, IN INFANTS OF DIABETIC MOTHER.

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:35 - 09:36
Presenter
  • Stefano Curto, Italy
Authors
  • Stefano Curto, Italy
  • Angela Zanfardino, Italy
  • Alessia Piscopo, Italy
  • Francesca Casaburo, Italy
  • Napolitano Marcello, Italy
  • Dario Iafusco, Italy

Abstract

Background and Aims

CGM is increasingly used to improve glucose monitoring in newborns at risk of fluctuating glucose levels, particularly hypoglycaemia, such as preterm infants, infants born to mothers with diabetes, and babies who are small or large for gestational age. Although, safety and effectiveness of the newest generation of CGM for people with diabetes ages 2 and up is well known, there is no evidence in newborns.

Aim of our study is to evaluate accuracy of the newest generation of CGM (Dexcom G6) in newborns of diabetic mother.

Methods

11 newborns of diabetic mother were recruited and monitored by CGM for the first 48 h of life. Blood glucose levels (SMBG) were performed at least every four hours. We calculated the difference between CGM and SMBG values, at the times of the capillary sample.

Results

The percentage difference was less than 12% considering all the values. The difference was reduced to 8% for values > 3.89 mmol/L and increased to 12% for values between 2.78 to 3.89 mmol/l. For values below 2.78 mmol/L the difference was of 14%.

Conclusions

The newest generation of CGM (Dexcom G6) could be use in newborns, especially in infants of diabetic mother who needs frequent blood sugar checks. Good correlation between SGMB and CGM values makes their use possible in neonatal intensive care. Further studies are needed to determinate the accuracy of Dexcom G6 in newborn.

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ASSESSMENT OF ANALYTICAL PERFORMANCE OF GLUCOSE METER IN PEDIATRIC AGE GROUP AT TERTIARY CARE REFERRAL HOSPITAL

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:36 - 09:37
Presenter
  • MOHIT V. Rojekar, India
Authors
  • MOHIT V. Rojekar, India
  • ARATI A. Adhe, India

Abstract

Background and Aims

Glucometers are the excellent tools for self-monitoring of blood glucose (SMBG). They are important especially in the circumstances where continuous monitoring is mandatory and at decision making levels. Tight glycemic control protocols are important for preventing the ill effects of fluctuating glucose levels. This increases the use of glucometers in various healthcare settings. As technology advances, glucometers are getting better in terms of quality of results. But still some lacunae are there.

Methods

Present study was conducted in the tertiary care referral hospital. One hundred twenty five patients were recruited from pediatric wards. Bland-Altman plot, Parke error grid and Surveillance error grid analysis were used for comparing results of glucose meter with that of standard laboratory method.

Results

It is found that there is significant difference between the results by two methods. Though minimal but glucose meter results deviate from the results of standard lab method. This will affect the overall patient care especially in emergency conditions.

Conclusions

This study is the first of its kind as no similar studies have been reported in the pediatric population. For effective use of glucose meter it should give as accurate as possible estimate of actual glucose levels. Results should not only be accurate but also precise without which critical errors may be possible. We recommend that for any glucose meter there should be regular maintenance as well as calibration is to be done. So that agreement with reference laboratory method is maintained and effective medical decisions are made.

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GLYCEMIA VARIABILITY (VG) IN CHILDREN WITH TD1 ACCORDING TO THE GLYCEMIC PROFILE

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:37 - 09:38
Presenter
  • Oleg Dianov, Russian Federation
Authors
  • Oleg Dianov, Russian Federation
  • Vadim Maltsev, Russian Federation
  • Ilya Anfilov, Russian Federation

Abstract

Background and Aims

We assessed VG according to the glycemic profile data in 126 children with TD1 - amplitude of fluctuations SD, MAGE, CV and their correlation.

Methods

We developed a program which can calculate indicators based on the data of the patient’s glycemic profile. To do this, enter the values from the data in the field and click "calculate indicators". The values ​​of the main VG indicators will appear on the screen. Amplitude of fluctuations in glycemia was 6.7 mmol/l (5.3; 8.7). CV 30.3% (25.9; 36.9) indicates frequent fluctuations in glycemia during the day. Indicator SD 2.62 σ (2.0; 3.28) confirms these changes, because it's connected with CV. MAGE was 4.4 mmol/L (3.5; 6.0), indicating its prevalence. The high correlation was between MAGE and the amplitude of fluctuations r=0.880 (p<0.01), between MAGE and CV r=0.779 (p<0.01), between SD and the amplitude of fluctuations r = 0.965, p<0.01. The correlation coefficient between CV and the amplitude of fluctuations was 0.784 (p<0.01).

Results

Significant fluctuations in glycemia, indicating an unsatisfactory course of the disease in most patients, were found.

Conclusions

All the considered VG indicators had a connection - the CV with all other indicators and the amplitude of fluctuations. An increase in amplitude of fluctuations can be considered with SD and CV as a feature of glycemic instability in the assessment of the patient’s glycemic profile.

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GLYCEMIA VARIABILITY INDICES AS A BASIS FOR BUILDING A NETWORK MODEL FOR PREDICTING THE COMPENSATION OF TYPE 1 DIABETES

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:38 - 09:39
Presenter
  • Marina Koshmeleva, Russian Federation
Authors
  • Marina Koshmeleva, Russian Federation
  • Julia Samoilova, Russian Federation
  • Olga Kobyakova, Russian Federation
  • Konstantin Brazovskii, Russian Federation
  • Oxana Oleynik, Russian Federation
  • Tatiyana Filippova, Russian Federation
  • Dariya Podchinenova, Russian Federation

Abstract

Background and Aims

Standard methods for determining the compensation of the disease don’t always reliably reflect the level of the glycemic control of the patient, which leads to decompensation diabetes and reduce the quality and duration of life for patients. Evaluation of glycemic variability indices allows the physicians to predict the risk of developing life-threatening conditions and compensate the diabetes

Aim: Identify the relationship of HbA1c and glycemic variability indexes to predict the compensation of diabetes

Methods

The study included 120 patients with diabetes type 1. Through the technology of CGM all patients transmitted data to the doctor for recommendations and done analysis of HbA1c. Using the EasyGV calculator, we calculated the glycemic variability indices, on the basis of which the regression neural network model was built in the statistical computing environment R using the neuralnet.

Results

Using CGM in patients with diabetes type 1, there was a significant improvement in the glycemic variability indices by the end of the study. HbA1c in the remote monitoring group decreased by 1.95% (p=0,016), in the outpatient observation group decreased by 0.7% (p≤0,001), in the standard therapy group increased by 0.05% with p=0.546.

Conclusions

The neural network model with a high index of determination based on glycemic variability indexes demonstrates a significantly higher accuracy in predicting the level of HbA1c in diabetes patients, which makes it possible to assess the degree of compensation for the disease and provide a personalized approach in treating these patients

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THE INFLUENCE OF SERUM VITAMIN D LEVELS ON BLOOD SUGAR CONTROL AND OSTEOPOROSIS IN TYPE 2 DIABETES PATIENTS

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:39 - 09:40
Presenter
  • Sheng Fong Kuo, Taiwan
Authors
  • Sheng Fong Kuo, Taiwan
  • Bie-Yui Huang, Taiwan

Abstract

Background and Aims

The importance of vitamin D for bone health is known in general population. However, whether the serum vitamin D level is closely associated with bone mineral density and blood sugar level in type 2 diabetes patients is not well established in Taiwan.

Methods

This study enrolled type 2 diabetes patients (postmenopausal women) not older than 65 years old who were seen in clinics in Chang Gung Memorial Hospital in Keelung, Taiwan. We had their blood tested for serum 25-hydroxyvitamin D [25(OH)D], CTX (Serum Beta-C-Terminal Telopeptides), bone alkaline phophatase (Bone-ALP,), and HbA1c and fasting blood sugar levels. Every patient underwent DEXA (Bone Densitometry) and T-L spine lateral view examinations. Patients were classified as 3 groups on the basis of their serum Vitamin D levels (Vitamin D: <20 ng/mL & 20-30 ng/mL & >30 ng/mL)

Results

There were 79, 113 and 71 patients for each group in Vitamin D: <20 ng/mL & 20-30 ng/mL & >30 ng/mL, and mean age 60.4, 60.1 and 60.9 years. Higher serum Vitamin D levels were correlated with lower LDL (p = 0.01) and higher HDL levels (p = 0.01). There were less events of microalbuminuria (p = 0.22) and better fasting blood sugar level (p = 0.07) with higher serum Vitamin D levels. However, no statistically difference were noted in BMI, HbA1C, renal function, B-CTx, Bone-ALP, T-score (DEXA) and compression fracture rate in each groups.

Conclusions

Our data shows no correlation between serum Vitamin D levels and blood sugar control & osteoporosis in type 2 diabetes patients.

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IMPACT OF INCREASED EXERCISE WORKLOAD VOLUME OF HIGH-INTENSITY INTERVAL TRAINING ON HOME CAPILLARY BLOOD GLUCOSE MONITORING IN PATIENTS WITH TYPE 1 DIABETES.

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:40 - 09:41
Presenter
  • Alejandro José Laguna sanz, Spain
Authors
  • Rodrigo M. Martin-san agustín, Spain
  • Alejandro José Laguna sanz, Spain
  • Jorge Bondia, Spain
  • Francisco Javier Ampudia-blasco, Spain

Abstract

Background and Aims

Exercising using high intensity interval training (HIIT) may help in improving glycemic control in diabetes. Although high workload volume HIIT may have increased health benefits, an adequate workload progression should be programmed when initiating HIIT. Our objective was to examine the effect on home capillary blood glucose monitoring (HCGM) of an exercise program of increasing volume in people with type 1 diabetes.

Methods

Exercising using high intensity interval training (HIIT) may help in improving glycemic control in diabetes. Although high workload volume HIIT may have increased health benefits, an adequate workload progression should be programmed when initiating HIIT. Our objective was to examine the effect on HCGM of an exercise program of increasing volume in people with type 1 diabetes.

Results

For all periods, there was a reduction of 1-h post-exercise HCGM compared with basal values before beginning each session. In addition, from the first period (one exercise series) through the third period (three series), a sudden drop of HCGM was observed between beginning and end of sessions but less between immediately and 1-h post-exercise.

capiullary.jpg

Conclusions

Increasing progressively exercise workload volume with HIIT over 12 weeks decreased slightly and progressively HBGM just after exercise but not 1-h post-exercise in people with type 1 diabetes.

Funding: Spanish Gov. DPI2016-78831-C2-1-R, FEDER funds, UPV PAID-06-18

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ASSOCIATION OF 1,5-ANHYDRO-D-GLUCITOL AND INSULIN RESISTANCE IN TYPE 2 DIABETES MELLITUS PATIENTS WITH ST SEGMENT ELEVATION MYOCARDIAL INFARCTION

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:41 - 09:42
Presenter
  • Yelena Laryushina, Kazakhstan
Authors
  • Yelena Laryushina, Kazakhstan
  • Dinara N. Sheryazdanova, Kazakhstan
  • Larissa Muravlyova, Kazakhstan
  • Ludmila Turgunova, Kazakhstan
  • Alexander Marchenko, Kazakhstan
  • Anar Turmukhambetova, Kazakhstan

Abstract

Background and Aims

The assessment of 1.5-AG and insulin resistance in patients with macrovascular complications of type 2 diabetes mellitus (T2DM) is the goal of this study.

Methods

We studied 114 patients with T2DM. First group included 42 patients with ST segment elevation myocardial infarction (STEMI), second group - 72 diabetic patients without STEMI. The studied parameters were clinical data, fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), 1,5-anhydro-D-glucitol (1,5-AG), and insulin. Statistical processing provided using Mann-Whitney U-test, Spearman's rank correlation coefficient, and binary logistic regression.

Results

There were 43.86% of men and 56.14% of women in the study. FPG in patients with STEMI (9.81 mmol/l, Q25-75:7.7-14.8) was higher (p=0.012) than in the second group (8.55 mmol/l, Q25-75:6.72-10.07). STEMI subjects had greater HOMA-IR (group 1: Me=7.91, Q25-75:2.86-11.37) compared with the second group (Me=5.89: Q25-75:1.73 -8.69, p=0.048). There was significant decrease of 1,5-AG among patients with T2DM and STEMI (first group: Me=215.85, Q25-75:186.35-280.77, second group: Me=314.64, Q25-75:250,83-415.08, p=0.000). The levels of insulin and HbA1c did not have significant differences between the groups. Weak positive correlation found between 1,5-AG and HOMA-IR for both groups (the first group r=0.183, p=0.008, the second group r=0.283, p=0.003). The negative association between 1,5-AG and STEMI established independent of such confounders as age, gender, income, hypoglycemic therapy [OR 1.16 (95%CI 1.0.25–1.316), p=0.019]. The association between HOMA-IR shows no impact on STEMI after adjusted on confounders. [OR 1,016 (95% CI0,979-1,055), p=0.406]

Conclusions

Association of 1.5 AD and STEMI suggests its potential predictive role on negative cardiovascular events prediction.

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PRELIMINARY ACCURACY ASSESSMENT OF THE LIBRE SENSOR WITH A SMART READER AND XDRIP+

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:42 - 09:43
Presenter
  • Fabian León-Vargas, Colombia
Authors
  • Fabian León-Vargas, Colombia
  • Daniel Silva, Colombia
  • Maira Garcia Jaramillo,

PREDICTORS OF CARDIOMETABOLIC RISKS AMONG THE TYPICAL AFRICAN ELDERLY POPULATION: ANALYSIS FROM DAR ES SALAAM, TANZANIA

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:43 - 09:44
Presenter
  • Kelvin M. Leshabari, Tanzania
Authors
  • Kelvin M. Leshabari, Tanzania
  • Wazir J. Ndonde, Tanzania
  • Sam Mbega, Tanzania
  • Luqmaan Mbululo, Tanzania

Abstract

Background and Aims

There is palpable evidence that sub-Saharan Africa is experiencing a demographic transition. Little is known about the predictors of cardiometabolic risk among the elderly segment of African population. This study aimed at assessing predictors of cardiometabolic risks among typical African elders.

Methods

A cross-sectional, community-based study was done among Ubungo Msewe residents in Dar es Salaam, Tanzania. Information on weight, height, fasting glycaemia, 2-hours post-prandial glycaemia, resting electrocardiogram, sitting systolic and diastolic blood pressures were performed. Continuous data were summarized using median (IQR) while categorical data were summarized using frequency (%). Generalised linear model was used to ascertain different association between variables. Chronbach’s alpha coefficient was used to estimate the reliability index. A verbal informed consent was sought from each participant prior to inclusion into the study.

Results

A total of 472 participants were recruited for screening. All participants were black Africans by race. Median age was 67 (IQR: 63-71) years. Male: Female = 1:3.1. There was a significant correlation between gender and blood pressure (γ = 0.52, p=0.000). BMI, 2-hour post-prandial glycaemia, systolic and diastolic blood pressure were significant predictors of cardiometabolic risks (chronbach’s α = 0.77, p=0.000) There was a significant correlation (γ=0.61, p=.02) between age and reported previous adverse cardiovascular events.

Conclusions

BMI, post-prandial glucose stress test and blood pressure significantly predicted the risk of cardiometabolic risks in this study population. Female gender was a significant predictor of blood pressure in this study population.

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ASSOCIATION OF TIME IN RANGE WITH CAROTID INTIMA-MEDIA THICKNESS IN TYPE 2 DIABETES

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:44 - 09:45
Presenter
  • Jingyi Lu, China
Authors
  • Jingyi Lu, China
  • Xiaojing Ma, China
  • Yun Shen, China
  • Qiang Wu, China
  • Ren Wang, China
  • Lei Zhang, China
  • Yifei Mo, China
  • Wei Lu, China
  • Wei Zhu, China
  • Yuqian Bao, China
  • Vigersky A. Robert, United States of America
  • Weiping Jia, China
  • Jian Zhou, China

Abstract

Background and Aims

There is evidence that time in range (TIR) correlates with microvascular complications of diabetes including diabetic retinopathy and albuminuria. We sought to investigate the association of TIR with carotid intima-media thickness (CIMT) as a surrogate marker of cardiovascular disease (CVD).

Methods

2, 215 hospitalized patients with type 2 diabetes were recruited. TIR of 3.9-10.0 mmol/L was evaluated with CGM. CIMT was measured using high-resolution B-mode ultrasonography and abnormal CIMT was defined as a mean CIMT ≥ 1.0mm. Logistic regression models were used to examine the independent association of TIR with CIMT.

Results

Patients with abnormal CIMT had significantly lower TIR as compared with those with normal CIMT (P < 0.001). The prevalence of abnormal CIMT progressively decreased across the categories of increasing TIR (P for trend <0.001). Each 10% increase in TIR was observed to be associated with 6.4% lower risk of abnormal CIMT after adjusting for conventional risk factors of CVD. In addition, we found TIR was significantly associated with CIMT in males but not in females. In a subset of patients (n=612) with complete data on diabetic retinopathy and albuminuria, the relationship between TIR and CIMT remained to be significant, regardless the status of microvascular complications.

Conclusions

TIR is associated with CIMT in type 2 diabetes, suggesting a link between TIR and CVD risk.

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PREVENTION AND REVERSION OF DIABETES TYPE 2(DMT2)

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:45 - 09:46
Presenter
  • Dora D. Mendoza, Colombia
Authors
  • Dora D. Mendoza, Colombia

Abstract

Background and Aims

ABSTRACT

This research has been taken more than 15 years in proven the accuracy

On what was learned from Professor Don Gregorio Marañón in his Institute

of Metabolism, Nutrition and Endocrinology, Madrid , Spain:

1-T2DM is dominantly transmitted to all generations

2- the only useful test to diagnose it is the Oral Glucose Tolerance Test (OGTT),

3- fasting test are not useful

4- the treatment is normal life style if not wanted the only medication useful is

insulin’s (basal or fast action)

Methods

More than thousand volunteers were studied using the OGTT

Results

6% of the studied were normal and had no family members with T2DM

The other 94% all had T2DM family members with T2DM. From these

13% had high levels of blood insulin

48% had Intolerance to Glucose

32% had Prediabetes

2% had asymptomatic hypoglycemia

Conclusions

The Dr. Gregorio Maranon’ teaching were proven scientific accurate

Methods

Methods

More than thousand volunteers were studied using the OGTT

Results

Results

6% of the studied were normal and had no family members with T2DM

The other 94% all had T2DM family members with T2DM. From these

13% had high levels of blood insulin

48% had Intolerance to Glucose

32% had Prediabetes

2% had asymptomatic hypoglycemia

Conclusions

Conclusions

The Dr. Gregorio Maranon’ teaching were proven scientific accurate

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DEFINING THE TARGET VALUE OF COEFFICIENT OF VARIATION IN CHINESE DIABETES PATIENTS

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:46 - 09:47
Presenter
  • Yifei Mo, China
Authors
  • Yifei Mo, China
  • Xiaojing Ma, China
  • Jingyi Lu, China
  • Lei Zhang, China
  • Wei Lu, China
  • Wei Zhu, China
  • Yuqian Bao, China
  • Jian Zhou, China
  • Weiping Jia, China

Abstract

Background and Aims

To define the target value of coefficient of variation (CV) in Chinese diabetes patients

Methods

A total of 3007 diabetes patients underwent continuous glucose monitoring (CGM). Type 2 diabetes were divided into groups according to the treatment: group 1, non-insulinotropic agent alone (n=138); group 2, oral therapy with insulinotropic agent (n=761); group 3, basal insulin therapy (n=100); group 4, premix insulin (n=784) and group 5, intensive insulin therapy (n=612). Another 612 type 1 diabetes were included as group 6. %CV and time per day within, below and above target glucose range were computed. TBR3.9 ≥4% and TBR3.0 ≥1% were defined as excessive hypoglycemia.

Results

Type 2 diabetes with premixed or intensive insulin regimens had increased %CV than those on oral therapy or basal insulin. The upper limit of %CV in group 1 was 33%, which was adopted as the threshold to define excess glycemic variability. In each group, the percentage of patients with TBR3.9≥4% was significantly greater in subgroup with %CV>33% than ≤33% (P<0.001). In well-controlled patients who had TBR3.9<4%, TIR3.9-10>70% and TAR10<25%, the 95th percentile of %CV was 32.70% (close to 33%). The optimal cutoff values for %CV as identifier of TBR3.9≥4% by ROC analysis were different in groups with different treatment or with different A1C ranges (27% in A1C 6-7% group; 30.1% in A1C 9-10% group and 35.1% in A1C≥10% group)

Conclusions

The target value of %CV seems to be 33% in Chinese diabetes. However, patients with different A1C ranges or different therapy should be considered to use a personized %CV target.

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PROSPECTIVE EVALUATION OF GLUCOSE RANGES AND NUTRITIONAL STATUS IN PERSONS WITH TYPE 1 AND INSULIN-TREATED TYPE 2 DIABETES

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:47 - 09:48
Presenter
  • Andreea Morosanu, Romania
Authors
  • Andreea Morosanu, Romania
  • Magdalena Morosanu, Romania

Abstract

Background and Aims

Continuous glucose monitoring(CGM) is currently the most precise evaluation of glucose status.Benefits and improvements of glucose control were shown over time.We investigated the evolution of glucose status in type 1 diabetes(T1D) and insulin-treated type 2 diabetes(ITT2D) persons evaluated by CGM, initially and after three months.

Methods

We assessed 21 persons:13-T1D,8-ITT2D;10 women,3 men,mean age 35.67±16.69 years(11-65),mean diabetes duration 8.48±5.96 years(0-19).Glucose distribution was assessed by number and percent of glucose values(NGV,%GV),area under the curve of glucose values(AUC),mean glucose values(MGV)on glucose domains(<70 mg/dl,>180 mg/dl,70-180 mg/dl,90-130 mg/dl).We measured HbA1c,body weight,body mass index(BMI),abdominal circumference(CA),total daily insulin dose(TDI),total daily carbohydrates intake(TDCH) and we performed CGM,initially and after three months.

Results

HbA1c was reduced significantly(S) from 8.56% to 7,4% and decreased in both T1D and ITT2D groups(S).MGV decreased(close to significance-CS).%GV>180 decreased(S),%GV<70,%GV70-180,%GV90-130 increased non-significantly(NS).Total AUC,decreased(NS);hourlyAUC decreased(CS);AUC>180,decreased(NS);AUC<70,increased(CS);AUC 70-180 and AUC 90-130 increased(NS);%AUC>180 decreased(S) and %AUC 70-180 increased(CS);diurnal AUC and nocturnal AUC decreased(NS);hourly diurnal AUC and hourly nocturnal AUC decreased(CS).TDI,insulin dose per kilogram of body weight and TDCH decreased(NS),body weight and BMI did not differ,AC decreased(NS).In ITT2D,%GV<70 and AUC<70 increased(CS),insulin dose decreased (NS),TDCH increased(S),body weight and AC increased(NS).In T1D,AUC 70-180 increased(S),TDCH decreased(S),body weight and BMI did not differ,AC decreased(S).

Conclusions

Following CGM intervention,more glucose values(%GV) and exposure(AUC) decreased under 180 mg/dl and more evident in T1D.Daily carbohydrate intake and abdonimal circumference decreased in T1D.More hypoglycemic values(<70mg/dl) were observed in ITT2D,although non-significant.Daily carbohydrate intake increased significantly in ITT2D,probably due to increase of hypoglycemia.

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GLYCAEMIC CONTROL IN T1D PATIENTS TREATED FROM CLINICAL ONSET IN A VALUE-BASED CARE CENTER VS. PATIENTS TRANSFERRED FROM OTHER CENTERS: THE DIABETER EXPERIENCE

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:48 - 09:49
Presenter
  • Dick Mul, Netherlands
Authors
  • Pim Dekker, Netherlands
  • Dick Mul, Netherlands
  • Martine De vries, Netherlands
  • Theo Sas, Netherlands
  • Henk-Jan Aanstoot, Netherlands
  • Henk Veeze, Netherlands

Abstract

Background and Aims

DIABETER delivers value-based T1D care resulting in better glycaemic control (vs. the Dutch average) among paediatric patients who were treated at DIABETER from diagnosis onwards (primary patients: 31%). However, 69% of patients received treatment in other clinics before they transferred to DIABETER (secondary patients). Recent studies show tracking of life-time HbA1c values and clinical inertia. We assess if our care model improves glycaemic control of secondary patients or if tracking prevents improvement toward glycaemic levels comparable to the primary patient group.

Methods

HbA1c values extracted from our disease management system Vcare were included for patients treated ≥1 year at DIABETER (n= 2014). Secondary patients were only included if they had received ≥1 year of previous care in another clinic. HbA1c changes, determined cross-sectionally per year from 2006-2018, were analysed descriptively for primary and secondary patients. Three hospitals (H1-3) discontinued T1D care and transferred their T1D patients to DIABETER, allowing study of both ‘en bloc’ and individual patient transfers from >40 other referring centers.

Results

fig.jpgHbA1c levels from primary patients (all age groups) fluctuate around 8.0 % over the years (figure). Secondary patients had higher HbA1c at the time they transferred to DIABETER, but the group gradually improved (over months to years) to HbA1c levels comparable with those of primary patients.

Conclusions

Transition to DIABETER results in improved glycaemic control comparable with our primary patients, showing value in our comprehensive care model which may also overcome tracking in (secondary) patients. Additional studies, including treatment, care methods, use of technology and patient-related factors, are needed.

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CORRELATION OF HBA1C WITH URINARY ACR AND E-GFR IN INDIAN DIABETICS

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:49 - 09:50
Presenter
  • Rishi Kumar Nigam, India
Authors
  • Rishi Kumar Nigam, India

Abstract

Background and Aims

Prevalence of Diabetes mellitus (DM)has reached epidemic proportions globally of which developing countries like India are likely to bear maximum burnt in 21st century, Diabetic nephropathy is a chronic micro vascular complication , leading to end stage renal disease (ESRD). Control of DM is monitored by HbA1c. There are two important early markers to asses renal impairment , glomerular filtration rate (GFR) & microalbuminuria . Microalbuminria is better reflected by spot urine albumin-creatinine ratio (Urinary ACR) and estimated GFR can be calculated by equations .Objective of the study was to evaluate the association of HbA1c with urinary ACR and eGFR in Type 2DM. patients.

Methods

A cross sectional study carried out in the department of Pathology and Clinical biochemistry of Rajeev Gandhi College, including 50 known type 2 DM patients of 40-75 years age were evaluated dividing them on the basis of HbA1c (<8%,>8%), duration of DM (>5 years, <5 years), Blood Glucose, Serum Creatinine, Urinary Albumin & Creatinine were estimated. eGFR and urinary ACR were calculated. Results were expressed as mean ± SD. Data were analyzed with SPSS. Pearson’s correlation tests were performed to assess level of significance.

Results

Study shows that, HbA1c has significant positive correlation with Urinary ACR & with S. Creatinine and there is significant negative correlation of HbA1c with eGFR more with HbA1c >8%. Duration of DM has less significant correlation with renal functional parameters.

Conclusions

Raised HbA1c is associated with urinary ACR. ACR should be estimated in monitoring risk assessment of Type 2DM in patients with raised HbA1c.

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ASSOCIATION OF HEMOGLOBIN A1C, GLYCATED ALBUMIN, AND 1,5-ANHYDRO-D-GLUCITOL ON OXIDATIVE STRESS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A CROSS-SECTIONAL STUDY

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:50 - 09:51
Presenter
  • Makoto Ohara, Japan
Authors
  • Makoto Ohara, Japan
  • Hiroe Nagaike, Japan
  • Yo Kohata, Japan
  • Hideki Kushima, Japan
  • Munenori Hiromura, Japan
  • Michishige Terasaki, Japan
  • Yusaku Mori, Japan
  • Tomoyasu Fukui, Japan
  • Sho-ichi Yamagishi, Japan

Abstract

Background and Aims

Previous studies reported that oxidative stress was associated with glucose variability measured by continuous glucose monitoring (CGM) in T2DM. The use of CGM, however, remains limited at present. We investigated the relationship between glycemic markers and oxidative stress in type 2 diabetes mellitus (T2DM).

Methods

Oxidative stress, hemoglobin A1c (HbA1c), and glycated albumin (GA) and 1,5-anhydro-D-glucitol (1.5-AG) were measured in 234 patients with T2DM. The oxidative stress was estimated using the diacron-reactive oxygen metabolites (d-ROMs) test. The associations of d-ROMs with GA, 1.5-AG, blood glucose, lipid metabolism markers, blood pressure, and clinical factors were examined.

Results

Fasting plasma glucose (FPG), HbA1c, GA, TG, and LDL-C were correlated with d-ROMs in all of the T2DM patients. HbA1c and TG were correlated with d-ROMs in T2DM patients with HbA1c < 8.0 %. FPG, HbA1c, and GA were correlated with d-ROMs in T2DM patients with HbA1c 8.0 %. An inverse correlation was found between 1.5-AG and d-ROMs in all of the patients and in patients with HbA1c < 8.0 %. The following factors were found to be independent of d-ROMs by stepwise multiple regression analysis: 1.5-AG, sex, GA, TG, and the use of metformin in all patients; 1.5-AG, sex, HbA1c, and the use of metformin in patients with HbA1c < 8.0 %; and GA, sex, and FPG in patients with HbA1c 8%.

Conclusions

Our data suggest that 1.5-AG reliably estimates oxidative stress in well-controlled T2DM and that GA reliably estimates oxidative stress in poorly controlled T2DM.

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THE USE OF FLASH GLUCOSE MONITORING (FGM) SYSTEM IN HEMOLYTIC ANEMIA (HA), A CASE REPORT

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:51 - 09:52
Presenter
  • Ronaldo J. Pineda-wieselberg, Brazil
Authors
  • Ronaldo J. Pineda-wieselberg, Brazil
  • João Eduardo Nunes salles, Brazil
  • Erika Bezerra parente, Brazil

Abstract

Background and Aims

We report the case of a woman with T2DM who presented hemolytic anemia (HA). The treatment with corticosteroids led to a great variability of her BG, as well as difficulty to manage her BG and falsely low A1c. A FGM was installed to allow better evaluation of her glucose profile.

Methods

HA treatment was made with Prednisone and a pulse of 3 days of Methylprednisolone. Her BG had great variations and her A1c was falsely low. We put a FGM system to evaluate the behaviour of glucose levels in her hospitalization and compared them with the BG results.

Results

Her A1c was 4.5%, but considering HA, it was considered unreal. After 3 days with the FGM, she had an estimated A1c of 9.6% (mean glucose of 229mg/dl) and time in-range (TIR) of 37%, while the mean BG was of 253mg/dl in the same period. After 3 days of insulin management, she had an estimated A1c of 7.5% (mean glucose of 163mg/dl) and TIR of 64%, with the mean of BG of 151mg/dl.

Conclusions

The case is the first one we know in which the hemoglobinopathy was acquired and treated with corticosteroids hindering T2DM management. It is one of the few cases in which the FGM was used in hospitalar environment for optimal diabetes management. The FGM is little studied in intra-hospitalar environments, but, the success of our case suggests that further studies should be conducted in order to evaluate the feasibility of this tool to help the management of challenging cases, not only outside, but even inside the hospital.

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EFFECTS OF MULTIPLE DAILY INJECTION THERAPY ON GLYCEMIC VARIABILITY IN A REAL FASTING IN TYPE 1 DIABETES EVALUATED BY CONTINUOUS GLUCOSE MONITORING (CGM)

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:52 - 09:53
Presenter
  • Adrian Proietti, Argentina
Authors
  • Juan P. Nogueira, Argentina
  • Ivana Villa, Argentina
  • Mariana Burgos, Argentina
  • Andrea Daghero, Argentina
  • Adrian Proietti, Argentina

Abstract

Background and Aims

This study compared the effects of multiple daily injection therapy (MDI) on glycemic variability in a real fasting with CGM technology in real- life condition of patients with type 1 diabetes (T1D).

Methods

This was a paralell trial in 47 T1D patients, with a mean age of 34 years, and glycosilated haemoglobin (HbA1c) level of 8.50%; 31 patients were treated MDI with glargina-100, 10 with detemir, 6 with degludec). We analyzed the patients in three groups of HbA1c, <7.5% (N=17), 7.5-8-8.8% (N=15) and >8.8% (N=15). We used CGM by evaluated the coefficient of variation (CV) and mean amplitude of glycemic excursions (MAGE), we defined real fasting before three hours to breakfast and real posprandial state by rest of day.

The primary end point was the change of CV and MAGE in real fasting. Secondary end points included CV and MAGE in posprandial state. We compared different subgroups of basal HbA1c and insulin basal therapy.

Results

the HbA1c was different (6.86±0.14 vs 8.24±0.10 vs 10.28±0.30; p=0.001).However we didn’t found differences between the groups respect to CV-fasting (28.65±2.53 vs 37.39±4.17 vs 30.81±2.73; p=0.14) and MAGE-fasting (162.70±24.25 vs 158.93±23.40 vs 135.60±22.84; p=0.68). We found the only significant differences in analysis of subgroups with MAGE-posprandial state (77.58±12.92 vs 83.66±13.27 vs 128.93±17.36; p=0.034). We didn’t found any differences in analysis of subgroups with different insulin basal therapy

Conclusions

In T1D patients under clinical practice conditions, subgroups Of HbA1c or insulin basal therapy were not different regarding glycemic variability in a real fasting period.

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MOTIVATIONAL INTERVIEW TO IMPROVE VASCULAR HEALTH IN ADOLESCENTS WITH POORLY CONTROLLED TYPE 1 DIABETES: A RANDOMIZED CONTROLLED TRIAL

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:53 - 09:54
Presenter
  • Mari-Anne Pulkkinen, Finland
Authors
  • Mari-Anne Pulkkinen, Finland
  • Anna-Kaisa Tuomaala, Finland
  • Matti Hero, Finland
  • Taisto Sarkola, Finland

Abstract

Background and Aims

To study if motivational interviewing (MI) added to standard educational care (SE) improves vascular health in adolescents with poorly controlled type 1 diabetes.

Methods

47 adolescents with type 1 diabetes of at least 2 years duration and HbA1c > 75 mmol/mol (> 9.0%) on two visits were randomized to MI+SE or SE, clinicaltrials.gov; NCT02637154.

Results

39 adolescents (20 MI + SE) completed the study. At 12 months, vascular health parameter changes were not statistically significantly different between MI + SE and SE (carotid-femoral pulse-wave velocity (PWV): mean difference 0.052 m/s (95% CI -0.395 – 0.500, p=0.81); carotid-radial PWV: 0.118 m/s (95% -0.478 – 0.713, p=0.69), carotid intima-media thickness (IMT): 0.002 mm (95% CI -0.37 – 0.40, p=0.93), systolic blood pressure (SBP) z-score: 0.495 (95% CI -0.099 – 1.09, p=0.10). At baseline, duration of type 1 diabetes was associated with radial IMT (r=0.430, p=0.007) and cfPWV (r=0.373, p=0.018), and carotid, femoral and brachial IMT were correlated with CGM-SD (r=0.440, p=0.017; r=0.377, p=0.048; r=0.387, p=0.038). There was an inverse association between CGM time-in-range (3.9-10.0 mmol/L) and crPWV (r=-0.476, p=0.022) changes. SBP change was associated with BMI change (r=0.374, p=0.019) and IMT change (r=0.461, p=0.016 for carotid IMT; r=0.498, p=0.010 for femoral IMT).

Conclusions

There was no effect of MI added to SE on vascular health parameters. Although disease duration and glycemic control were associated with vascular health at baseline, there were only limited associations between glycemic control and vascular health parameter changes. Vascular health parameter changes were interrelated suggesting clustering of cardiovascular risk.

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COST- EFFECTIVE ANALYSIS OF INTERATIVE RETROSPECTIVE CGM IN PEOPLE WITH TYPE 2 DIABETES IN PORTUGAL

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:54 - 09:55
Presenter
  • RT Ribeiro, Portugal
Authors
  • RT Ribeiro, Portugal
  • ROBERT A. Vigersky, United States of America
  • RITA Andrade, Portugal
  • OD Nascimento do, Portugal
  • FILIPE Raposo, Portugal
  • IDA Buompensiere, Switzerland
  • SIMONA De portu, Switzerland
  • STEPHANE Roze, France

Abstract

Background and Aims

The objective of this study was to assess the cost-effectiveness of retrospective CGM (rCGM) in people with type 2 diabetes (T2D).

Methods

The IQVIA CORE Diabetes model was used to perform cost-effectiveness analyses over patient lifetimes. Clinical data were sourced from the single-arm before/after ADJUST study. Type 2 patients already on insulin were equipped with a rCGM device. The use of the rCGM was associated with a reduction in HbA1c of -1.3%, from 9.4% (79 mmol/mol) at baseline to 8.1% (65 mmol/mol) at 12 months. Cost data, expressed in 2018 euros (EUR), were obtained from Portuguese reference prices and the published literature. A 5% discount rate was applied to both clinical and economic outcomes.

Results

rCGM was associated with a quality-adjusted life-year (QALY) gain of 0.09 per patient based on their remaining life expectancy (ca 24 years) but with higher overall costs 616 EUR, due to the costs of rCGM and related visits. This led to an incremental cost-effectiveness ratio (ICER) of EUR 6,765 per QALY gained. Use of rCGM would lower the cumulative incidence of diabetes-related complications. Higher rCGM acquisition costs were partially offset by reduced complication costs. Extensive sensitivity analysis on key drivers confirmed the robustness of results.

Conclusions

rCGM was associated with improved glycemic control and quality of life in peoples with T2D with elevated HbA1c and already on insulin. rCGM is a cost-effective management tool for people with T2D in Portugal.

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DETAILED EVALUATION OF THE RELATIONSHIP BETWEEN INTERMEDIATE-TERM GLYCEMIC VARIABILITY AND HYPOGLYCEMIA USING CONTINUOUS GLUCOSE MONITOR DATA

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:55 - 09:56
Presenter
  • SOICHI Takeishi, Japan
Authors
  • SOICHI Takeishi, Japan
  • Hiroki Tsuboi, Japan

Abstract

Background and Aims

The relationship between intermediate-term glycemic variability and hypoglycemia is well unknown, therefore, we analyzed that relationship using continuous glucose monitor (CGM) data.

Methods

We cross-sectionally analyzed CGM (FreeStyle Libre Pro) data for 97 patients with type 2 diabetes whose 24 h glucose levels were measured continuously for 13 days during hospitalization for type 2 diabetes treatment. Values over a span of 13 days for all glycemic variability and hypoglycemia metrics were evaluated. We have proposed novel glycemic variability metrics as follows: mean of daily difference 1 (MODD1) ÷ mean glucose level × 100 (MODD1/mean), mean absolute glucose (MAG) ÷ mean glucose level × 100 (MAG/mean), and glycemic variability percentage (GVP) ÷ mean glucose level × 100 (GVP/mean).

Results

The standard deviation (SD), MODD1, MAG, GVP, and the mean glucose level significantly negatively correlated with the percentage of time in the hypoglycemic range (< 70 mg/dL) [TIR < 70] (r = -0.32 – -0.75, p = 0.002 ~ < 0.001). Coefficient of variation (CV) tended to correlate with TIR < 70 positively. MODD1/mean, MAG/mean, and GVP/mean significantly positively correlated with TIR < 70. CV, MODD1/mean, MAG/mean, and GVP/mean significantly positively correlated with the percentage of time in the hypoglycemic range (< 54 mg/dL) [TIR < 54] (Table).attd 2020 3 figure.jpg

Conclusions

Intermediate-term glycemic variability which is divided by the mean glucose level may predict hypoglycemia.

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INPATIENT HYPOGLYCAEMIA - UNDERSTANDING WHO IS AT RISK

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:56 - 09:57
Presenter
  • Yue Ruan, United Kingdom
Authors
  • Yue Ruan, United Kingdom
  • Zuzana Moysova, United Kingdom
  • Garry Tan, United Kingdom
  • Alistair Lumb, United Kingdom
  • Jim Davies, United Kingdom
  • Rustam Rea, United Kingdom

Abstract

Background and Aims

We analysed data obtained from electronic patient records from inpatients with diabetes admitted to a large university hospital.

Methods

The study was conducted using electronic patient record data from Oxford University Hospitals NHS Foundation Trust. The dataset contains hospital admission data for patients with diabetes. We define a biochemical hypoglycemic episode as any blood glucose measurement < 4mmol/l and a clinically significant hypoglycemic episode as any blood glucose measurement <3mmol/l. Any two or more than two consecutive low blood glucose within a 4-hour time window are considered as one hypoglycemic episode.

Results

We analyzed data obtained from 17,658 inpatients with diabetes [1,696 type 1 diabetes, 14,006 type 2 diabetes, 9,277 males, age 66(18) years, mean(SD)] who underwent 32,758 hospital admissions between 2014 and 2018. We identified all the biochemical and clinically significant hypoglycemic episodes during these admissions. The incidence of biochemical hypoglycemia was 21.5% and that of clinically significant hypoglycemia was 9.6%. Major findings from the data analysis include: Recurrent biochemical and clinically significant hypoglycemia happened during 50% and 39% of hospital admissions with at least one hypoglycemic episode; Patients on metformin alone had the lowest incidence of hypoglycemia(8%) comparing to those on rapid analogue, long analogue and human rapid insulin at the same time, with the highest incidence (53%); Incidence of biochemical hypoglycaemia in type 1 diabetes(37%) doubles that in type 2 diabetes(18%).

Conclusions

Retrospective analysis of data from electronic patient records helps gain clinical understanding about inpatient hypoglycaemia and may improve inpatient glycaemic control through targeting high-risk hypo-prone inpatients.

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PROTEIN BASED BREAKFAST IMPROVES POST BREAKFAST HYPERGLYCEMIA

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:57 - 09:58
Presenter
  • Smita J. Shah, India
Authors
  • Smita J. Shah, India
  • Banshi D. Saboo, India
  • Vaishnavi K. Raval, India
  • Malay N. Parekh, India

VARIABILITY OF GLYCEMIA IN PATIENTS WITH 2 TYPE DIABETES

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:58 - 09:59
Presenter
  • Khaider Sharafetdinov, Russian Federation
Authors
  • Khaider Sharafetdinov, Russian Federation
  • Oxana Plotnikova, Russian Federation
  • Victory Pilipenko, Russian Federation
  • Ravila Alexeeva, Russian Federation

Abstract

Background and Aims

Aim: to assess the variability of glycemia (GV) in patients with type 2 diabetes on the background of a low-calorie diet with the inclusion of a specialized food (SF) with a modified carbohydrate profile.

Methods

Materials and methods: 38 women with type 2 diabetes and obesity (BMI on average 38.1 ± 0.89 kg/m2) aged 37 to 69 years were examined. All patients receiving standard hypoglycemic therapy were assessed for GV using the continuous glucose monitoring system from Medtronic for 6 days: 3 days against the background of a low-calorie diet (1,500 kcal / day) and 3 days against the background of a low-calorie diet with the inclusion of a SF for medical nutrition. SF was included in the hypocaloric diet in the form of a drink in the amount of 200 ml for a second breakfast instead of a carbohydrate-containing dish.

Results

Results: It is shown that the inclusion of SF in the hypocaloric diet was accompanied by a statistically significant decrease in the level of maximum and average glycemia. For the majority of patients over the entire observation period, the average glycemia in the afternoon and in the evening was higher than at night, reflecting the natural effect of meals on glycemia.

Conclusions

Conclusions: modification of the hypocaloric diet due to the inclusion of SF with a modified carbohydrate profile helps to reduce some indicators of hepatitis B in patients with type 2 diabetes.

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EVALUATION OF THE PROFILE OF BLOOD GLUCOSE USING CGM IN THE POPULATION WITH NORMAL ORAL GLUCOSE TOLERANCE TEST.

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:59 - 10:00
Presenter
  • Sheyda Sofizadeh, Sweden
Authors
  • Sheyda Sofizadeh, Sweden
  • Anders Pehrsson, Sweden
  • AF Ólafsdóttir, Sweden
  • Aldina Pivodic, Sweden
  • Marcus Lind, Sweden

Abstract

Background and Aims

CGM-data is essential in both clinical practice and diabetes studies for evaluating glucose control. To understand what glucose profiles should be judged as normal and for target values in persons with diabetes, we examined the glucose profile in healthy individuals.

Methods

Persons without known diabetes or prediabetes were included after passing a normal oral glucose tolerance test, 2-hour value <8.9 mmol/l, fasting glucose <6.1 mmol/l, HbA1c <42 mmol/mol (6.0%). During days 1-8 they wore masked CGM (DexCom G4). During days 8-14 they had an open CGM-system with an alarm at 4.0 mmol/l to regularly confirm with a HemoCue capillary meter the low glucose-levels.

Results

In total 60 persons were included, mean age was 43 years, 70% women, mean HbA1c 34 mmol/mol (5.3%) and mean BMI 25.7 kg/m2. Mean glucose level days 1-7 was 5.83 mmol/l and mean time with hypoglycaemia <4.0 mmol/l /24h was 51 minutes (mean 3.54%, median 1.92 % [range 0.0-25.5%]) and mean time with <3.0 mmol/l /24h was 7.10 minutes (mean 0.49%, median 0.0% [range 0.0-9.5%]). The mean SD was 1.15 mmol/l, CV 0.20 and MAGE 2.63 mmol/l. Mean time with glucose levels >10 mmol/l /24h was 20.8 minutes (mean 1.44%, median 0.25% [range 0.0-19.7%]).

Conclusions

CGM-profiles in persons without diabetes or prediabetes show around 2% of time with glucose levels <4.0 mmol/l and 0%-0.5% <3.0 mmol/l. An SD and CV close to 1.15 mmol/l and 20% respectively should be viewed as a glucose variability close to that of persons without prediabetes or diabetes.

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SERUM URIC ACID AND ALL-CAUSE OR CARDIOVASCULAR MORTALITY IN CHINESE ELDERLY MALE PATIENTS WITH IMPAIRED GLUCOSE TOLERANCE

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
10:01 - 10:02
Presenter
  • Hao Wang, China
Authors
  • Hao Wang, China
  • Guang Yang, China
  • Xiao Liang, China
  • Yang Liu, China

Abstract

Background and Aims

This prospective study examined whether baseline serum uric acid (SUA) levels predict all-cause or cardiovascular disease (CVD) mortality in Chinese elderly male adults with impaired glucose tolerance (IGT).

Methods

Between Apr 1st 2006 and Aug 31th 2015, 2676 elderly men underwent an oral glucose tolerance test (OGTT), SUA measurement and assessment of traditional CVD risk factors in health check up. Of these, 361 individuals were diagnosed as IGT. The cohort included 334 participants, who were followed for a mean period of 5.82 years. The independent association between SUA concentrations with all-cause or cardiovascular mortality or non CVD mortality was assessed by Cox proportional hazards models with or without adjustment for conventional risk factors and several potential confounders.

Results

Baseline age was 66-100 years. During follow-up, 61 (18.26%) patients died, 19.67% (n=12) of whom were attributed to cardiovascular causes. However, the most frequent causes of death were cancer (n=21; 34.42% of total) and pneumonia (n=21, 34.42% of total). In univariate analysis, baseline SUA levels were not significantly associated with increased risk of all-cause or cardiovascular mortality. After adjustment for age, history of previous CVD, history of previous CVD events, smoking status, BMI, fasting blood glucose, systolic blood pressure, diastolic blood pressure, serum total cholesterol, serum triglycerides and glomerular filtration rate, SUA had limited influence on cardiovascular mortality or all-cause or non-cardiovascular mortality.

Conclusions

SUA levels were not associated with increased risk of cardiovascular mortality or all-cause mortality in Chinese elderly male patients with IGT, independent of several potential confounders.

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ASSOCIATION BETWEEN CONTINUOUS GLUCOSE MONITORING DERIVED TIME IN RANGE AND MICROALBUMINURIA IN TYPE 2 DIABETES

Session Name
BLOOD GLUCOSE MONITORING AND GLYCEMIC CONTROL IN THE HOSPITALS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
10:02 - 10:03
Presenter
  • Jee Hee Yoo, Korea, Republic of
Authors
  • Jee Hee Yoo, Korea, Republic of
  • Gyuri Kim, Korea, Republic of
  • Kang Hee Sim, Korea, Republic of
  • Sang-Man Jin, Korea, Republic of
  • Hyung Jung Lee, Korea, Republic of
  • You-Cheol Hwang, Korea, Republic of
  • Jae Hyeon Kim, Korea, Republic of

Abstract

Background and Aims

As the use of the continuous glucose monitoring (CGM) increased, the time in range (TIR) derived from CGM are now emerging as the core metric for clinical target and assessing diabetic complication beyond HbA1c. This study investigated the association between the CGM-derived TIR and microalbuminuria.

Methods

A total of 835 subjects with type 2 diabetes who underwent three-day CGM and urinary albumin-to-creatinine ratio were retrospectively reviewed. TIR was defined as the percentage of time spent within the glucose range of 70-180 mg/dL. Microalbuminuria was defined as albumin-to-creatinine ratio more than 30 mg/g.

Results

Mean TIR of 3-day CGM data was 60.6 ± 25.9%. The overall prevalence of microalbuminuria was 40%. The prevalence of microalbuminuria decreased significantly with each TIR quartiles (Q1: 51.6%, Q2: 43.5%, Q3: 38.6%, Q4: 25.7%, p for trend < 0.001). Multiple logistic regression analysis revealed that the odds ratio of having microalbuminuria was 0.91 (95% CI: 0.86-0.98, p for trend = 0.005) per 10% increase in TIR after adjusting for multiple factors including use of ARB or ACE inhibitors. After further adjustment for glycemic variability (standard deviation and coefficient variation), the association between TIR and microalbuminuria still remained.

Conclusions

TIR is strongly associated with microalbuminuria in type 2 diabetes.

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