71 - THE ROLE OF TECHNOLOGY IN REAL-LIFE AND THE MANAGEMENT OF GLUCOSE VARIABILITY IN CHILDREN AND ADOLESCENTS WITH TYPE 1 DIABETES AND CELIAC DISEASE
Abstract
Background and Aims
Celiac disease (CD) can be associated to type 1 diabetes (T1D). Its treatment consists of a gluten-free diet. Some gluten-free foods have a high glycemic index, hypercaloric/low-fiber content and may affect glycaemic excursions. The aim of this study was to compare glucose monitoring (GM) profile of the last 14 days of subjects with T1D+CD on gluten-free diet to that with T1D alone.
Methods
All the subjects wore a glucose sensor (flash or continuous GM) and were on insulin pump (CSII) or multidaily injection (MDI) regimen. Insulin delivery sistems with predictive algorithms were excluded.
Results
155 subjects were studied, 43.5% males, mean age at T1D onset 6.3yrs±3.8 (T1D+CD 5.3yrs± 3.8vsT1D 7.0±3.7, p=0.006), mean age at study visit 12yrs ±3.9, mean % time sensor active 87,5%±13.1. Comparing patients with T1D+CD (n= 65) to those with T1D (n= 90), there were no significant differences in HbA1c (7,41%±0,8vs7,26±0,9 respectively), Time in range 70-180 mg/dl (53,0%±17,1vs53,3%±17,9), Time<70 mg/dl (3,3±3,0vs4,6±4,3), time>180 mg/dl (43,6±17,9vs42,2±18,9) and Coefficient of Variation (36,8±6,6vs37,5±7,0). Comparing patients with T1D+CD on CSII (n=33) to MDI (n=32), no significant differences in HbA1c (7,53% ±0,8vs7,3±0,9 respectively), time<70 mg/dl (2.9%±2.5vs3.7%±3.4), Coefficient of variation (35.9%±6.7vs37.8%±6.5), but higher time in range 70-180 mg/dl (58.6%±15.0vs47.5%±17.4, p=0.009), lower time>180 mg/dl (38.3%±16.0vs48.8%±18.4, p=0.025).
Conclusions
The use of GM allows patients on gluten-free diet to obtain a metabolic control comparable to that of patients without CD. The use of an integrated therapy with CSII has proved to be superior in improving metabolic control increasing the time in range 70-180 mg/dl.
