RELATIONSHIP OF SHORT- AND MID-TERM GLUCOSE VARIABILITY WITH BLOOD PRESSURE PROFILE PARAMETERS IN ADOLESCENTS AND YOUNG ADULTS WITH TYPE 1 DIABETES

Objective: The aim of the study was to investigate the association between blood pressure (BP) profile parameters and short- and mid-term glucose variability (GV) in young individuals with Type 1 Diabetes (T1D). Design and method: Individuals aged 12-30 years with T1D underwent simultaneous 24h-ambulatory BP monitoring (ABPM) (20-min intervals, Microlife WatchBP O3) and continuous glucose monitoring for 3 days (day before-during-after ABPM). GV indices [standard deviation (SD), coefficient of variation (CV), mean sensor glucose levels (MSG), mean amplitude of glycemic excursions (MAGE), time in range (TIR)] were assessed for 24h of ABPM, as well as for the 3 days. BP profile parameters (mean values, SD, CV, nighttime BP dip) were also evaluated. Results: 61 individuals were analyzed [34 males (56%), 35 (58%) on insulin pump therapy, mean age 22±5.6 years, BMI 23±4 kg/m2, HbA1c 7.1±1.0%, T1D duration 11±6.6 years, 24h ABPM 111±8.4/67±5.4 mmHg (systolic/diastolic), 24h ambulatory hypertension 4.9%]. Nighttime BP dip was inversely correlated with 24h nighttime MAGE (r=-0.30/-0.26 systolic/diastolic, p<0.04), whereas nighttime pulse pressure (PP) was inversely correlated to 24h TIR (r=-0.25, p=0.05). 24h daytime MAGE demonstrated inverse associations with SD and CV of daytime HR (r=-0.26/-0.26, p=0.04). A trend was observed between 24h nighttime MAGE and SD and CV of nighttime systolic BP (r=-0.20/-0.23, p=0.1/0.08 respectively). Furthermore, T1D duration was correlated with nighttime HR (r=0.26, p=0.04) and SD of nighttime diastolic BP (r=0.29, p=0.03). When GV indices derived from the 3-day period were examined, nighttime systolic BP correlated with 3-day MAGE (r=0.25, p=0.05) and inversely with 3-day TIR (r=-0.28, p=0.03). Lastly, daytime systolic BP was associated with 3-day daytime MAGE (r=0.28, p=0.03) and 24h systolic BP with 3-day SD of glucose (r=0.28, p=0.03) and 3-day MAGE (r=0.27, p=0.03). Conclusions: These data suggest that in young individuals with T1D there is a relationship between GV and BP parameters. The average BP levels, as well as nocturnal BP dip, were associated with several indices of GV, implying a potential common pathophysiologic background.