To evaluate the relationship between the GRI -component of hypoglycemia (CHypo) and hyperglycemia (CHyper)- with diabetes quality of life (DQoL), diabetes-related stress (DDS), perception of hypoglycemia (Clarke Test), visual analogic scale (VAS) and diabetes-knowledge (DKQ2) in T1D. Cross-sectional study in 92 patients with T1D under intensive insulin treatment (21.7

La monitorización flash de glucosa en pacientes con diabetes tipo 1 proporciona nuevos datos glucométricos que permiten evaluar el control glucémico más allá de la HbA1c. El objetivo del presente estudio fue evaluar la relación de la HbA1c, el tiempo en rango (TIR) y la variabilidad glucémica en una cohorte de pacientes pediátricos y adultos con diabetes tipo 1 y monitorización flash de glucosa. Estudio transversal en 195 pacientes con diabetes tipo 1 (42,6% mujeres, 70 pediátricos, 26,2% infusor subcutáneo de insulina, 28,7% coeficiente de variación [CV] ≤ 36%) en tratamiento intensivo y monitorización flash de glucosa. Se evaluaron datos clínicos, analíticos y glucométricos. La relación entre el TIR y la HbA1c mostró una correlación lineal fuerte negativa (R = −0,746; R2 = 0,557; p < 0,001), modificada en pacientes con CV ≤ 36% (R = −0,852; R2 = 0,836) frente a aquellos con un CV > 36% (R = −0,703; R2 = 0,551). Esta misma correlación se observó al evaluar el TIR y el Glucose Management Indicator(R = −0,846; R2 = 0,715; p < 0,001), tanto en pacientes con CV ≤ 36% (R = −0,980; R2 = 0,960) como en aquellos con CV > 36% (R = −0,837; R2 = 0,701); p < 0,001. Ambas correlaciones se mantuvieron estables al ser evaluadas de manera independiente en población pediátrica (R = −0,724; R2 = 0,525; p < 0,001), adultos (R = −0,706; R2 = 0,498; p < 0,001) y por tipo de tratamiento: múltiples dosis de insulina (R = −0,747; R2 = 0,558; p < 0,001) e infusor subcutáneo de insulina (R = −0,711; R2 = 0,506; p < 0,001). En un modelo de regresión multivariante adoptando la HbA1c como variable dependiente, exclusivamente el TIR (β = −0,031; p < 0,001), el CV (β = 0,843; p < 0,05) y la interacción TIR-CV (β = −0,017; p < 0,01) mantuvieron la significación estadística. La variabilidad glucémica definida por el CV modifica la relación entre el TIR y la HbA1c/Glucose Management Indicator y debe tenerse en cuenta a la hora de individualizar objetivos de TIR, independientemente de la edad o el tipo de tratamiento utilizado. Flash glucose monitoring in patients with type 1 diabetes provides new glucometric data that allow for the assessment of glycemic control beyond HbA1c. The objective of the study was to evaluate the relationship between HbA1c, time-in-range (TIR) and glycemic variability in a cohort of pediatric and adult patients with type 1 diabetes and treatment with flash glucose monitoring. This was a cross-sectional study in 195 patients with type 1 diabetes (42.6% females, 70 pediatric, 26.2% continuous subcutaneous insulin infusion, 28.7% coefficient of variation [CV] ≤ 36%) in intensive treatment and flash glucose monitoring. Clinical, analytical and glucometric data were evaluated. The relationship between the TIR and HbA1c showed a strong negative linear correlation (R = −0.746; R2 = 0.557; P < .001), modified in those patients with CV ≤ 36% (R = −0.852; R2 = 0.836) compared to CV > 36% (R = −0.703; R2 = 0.551). A similar correlation was found when evaluating the TIR and the Glucose Management Indicator (R = −0.846; R2 = 0.715; P < .001); in patients with CV ≤ 36% (R = −0.980; R2 = 0.960) versus CV > 36% (R = −0.837; R2 = 0.701); P < .001. Both correlations remained stable in the pediatric population (R = −0.724; R2 = 0.525; P < .001) and adults (R = −0.706; R2 = 0.498; P < .001) and by type of treatment: multiple doses of insulin (R = −0.747; R2 = 0.558; P < .001) and continuous subcutaneous insulin infusion (R = −0.711; R2 = 0.506; P < .001). In a multiple regression analysis evaluating HbA1c as dependent variable, the only parameters that maintained statistical significance were the TIR (β = −0,031; P < .001), CV (β = 0,843; P < .05) and TIR-CV interaction (β = −0,017; P < .01). The glycemic variability defined by the CV modifies the relationship between the TIR and HbA1c/Glucose Management Indicator and should be taken into account when individualizing TIR targets, regardless of age or the type of treatment used.

Objectives: Flash glucose monitoring in patients with type 1 diabetes provides new glucometric data that allow for the assessment of glycemic control beyond HbA(1c). The objective of the study was to evaluate the relationship between HbA(1c), time-in-range (TIR) and glycemic variability in a cohort of pediatric and adult patients with type 1 diabetes and treatment with flash glucose monitoring. Material and methods: This was a cross-sectional study in 195 patients with type 1 diabetes(42.6% females, 70 pediatric, 26.2% continuous subcutaneous insulin infusion, 28.7% coefficient of variation [CV] <= 36%) in intensive treatment and flash glucose monitoring. Clinical, analytical and glucometric data were evaluated. Results: The relationship between the TIR and HbA(1c) showed a strong negative linear correlation (R = -0.746; R-2 = 0.557; P < .001), modified in those patients with CV <= 36% (R = -0.852; R-2 = 0.836) compared to CV > 36% (R = -0.703; R-2 = 0.551). A similar correlation was found when evaluating the TIR and the Glucose Management Indicator (R = -0.846; R-2 = 0.715; P < .001); inpatients with CV <= 36% (R = -0.980; R-2 = 0.960) versus CV > 36% (R = -0.837; R-2 = 0.701); P < .001. Both correlations remained stable in the pediatric population (R = -0.724; R-2 = 0.525; P < .001) and adults (R = -0.706; R-2 = 0.498; P < .001) and by type of treatment: multiple doses of insulin (R = -0.747; R-2 = 0.558; P < .001) and continuous subcutaneous insulin infusion (R = -0.711; R-2 = 0.506; P < .001). In a multiple regression analysis evaluating HbA(1c) as dependent variable, the only parameters that maintained statistical significance were the TIR (beta = -0,031; P < .001), CV (beta = 0,843; P < .05) and TIR-CV interaction (beta = -0,017; P < .01). Conclusions: The glycemic variability defined by the CV modifies the relationship between the TIR and HbA(1c)/Glucose Management Indicator and should be taken into account when individualizing TIR targets, regardless of age or the type of treatment used. (C) 2021 SEEN y SED. Published by Elsevier Espana, S.L.U. All rights reserved.