Presenter of 1 Presentation
YOUTH WITH TYPE 1 DIABETES BENEFIT FROM EARLY CONTINUOUS GLUCOSE MONITORING INITATION IRRESPECTIVE OF DIABETIC KETOACIDOSIS AT DIAGNOSIS: 4T PILOT STUDY RESULTS
Abstract
Background and Aims
The 4T pilot study offered continuous glucose monitoring (CGM) to youth with type 1 diabetes (T1D) within 1 month of diagnosis. Diabetic ketoacidosis (DKA) at diagnosis is associated with short- and long-term complications. Our aim was to determine the impact of the 4T pilot study on hemoglobin A1c (HbA1c) levels in youth who presented in DKA versus without DKA across 12 months.
Methods
In the 4T pilot study (n=135), HbA1c levels were compared in youth that presented in DKA (n=67) at T1D diagnosis versus youth without DKA (n=68) at diagnosis. HbA1c levels were evaluated using a locally estimated scatter plot smoothing (LOESS).
Results
Youth with DKA at diagnosis had a higher starting HbA1c at diagnosis (12.6 ± 2.0%) compared to youth without DKA (11.9 ± 2.2%) at diagnosis (Figure 1). Youth with DKA at diagnosis also had an earlier and higher HbA1c (nadir 6.9% at 4 months) than the group with no DKA at diagnosis (nadir 6.3% at 5 months). Although HbA1c levels had a slight drift upward in the group with DKA at diagnosis at 12-months, the overall HbA1c trajectory remained steady across 12 months post-diagnosis in both groups.
Conclusions
In the 4T program, we observed an improvement in HbA1c trajectories for youth, irrespective of DKA presentation at diagnosis. However, these data highlight the potential need for additional support for youth that present in DKA at diagnosis to achieve recommended clinical HbA1c targets and programs to diagnose T1D before DKA develops.
