P-107: Metabolic targets achieved in patients with type 1 diabetes at a hospital in Buenos Aires, Argentina
M Silberkasten, N Grimberg, C Mannucci, M E AndresAbstract
Introduction
Achieving glycemic targets and managing cardiovascular risk factors reduces diabetes complications. The American Diabetes Association (ADA) and the International Society for Pediatric and Adolescent Diabetes (ISPAD) have proposed metabolic goals. Assessing the extent to which these targets are achieved in our setting is relevant.
Objectives
To describe the proportion of type 1 diabetes (T1D) patients achieving glycated hemoglobin (HbA1c) targets. Secondary objectives: estimate cardiovascular risk factors prevalence and explore factors associated with target achievement.
Methods
Retrospective, descriptive, cross-sectional study based on medical record review. Inclusion criteria: pediatric T1D patients with >1 year of disease duration, treated at Elizalde’s Hospital in Buenos Aires, with laboratory data from the study period. Outcome variables: HbA1c, LDL cholesterol, blood pressure, BMI z-score. Covariates: sex, age, diabetes duration, diabetic ketoacidosis at diagnosis, chronic complications, health care provider, treatment.
Results
281 patients were included; 53% female (n = 149). Median age 13.3 years (10.3–16.3), median diabetes duration 4.42 years (2.6–7.8). At onset, 65% (n = 183) presented with ketoacidosis. Median HbA1c was 8.8% (7.7–10.2). Overall, 87.5% of patients (n = 246) did not meet the HbA1c target and only 8.9% (n = 25) achieved all ADA/ISPAD clinical goals. Good glycemic control (HbA1c <7%) was associated with continuous glucose monitoring use (p = 0.0001), insulin pump therapy (p = 0.000001) and shorter diabetes duration (p = 0.04). Poor control was associated with ketoacidosis at onset (p = 0.015). Children aged 6–11 years had the best glycemic control, with a median HbA1c of 8.5% (7.7–9.4).
Conclusions
Achieving ADA/ISPAD goals in T1D patients in our setting is challenging. Improved access to diabetes technology may help optimize glycemic control. Comprehensive management of cardiovascular risk factors should be reinforced.