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  • 1
    In: Journal of the Endocrine Society, The Endocrine Society, Vol. 5, No. Supplement_1 ( 2021-05-03), p. A461-A462
    Abstract: Optimal glycemic control is required to lower the risk of complications in type 1 diabetes mellitus (T1DM). This can be achieved with multiple daily insulin injections (MDI) or with continuous subcutaneous insulin infusion (CSII). Most diabetes guidelines recommend a proportion of basal insulin (basal proportion of total insulin dose; %B/T) around 50% of the total daily dose (TDD), although there is scarce evidence that suggests that a lower %B/T is associated with lower HbA1c levels. Our objective was to evaluate the association of the %B/T with glycemic and microvascular outcomes. We included 132 T1DM adults of the Diabetes Clinic in a tertiary care center, 117 (88.6%) using MDI and 15 (11.4%) using CSII. Data from the medical records and insulin pumps software during outpatient visits were retrospectively collected. Individuals with end-stage renal disease, solid-organ transplant, pregnancy, and glucocorticoid use were excluded. A positive correlation between %B/T and HbA1c levels was found, r=0.26 (p=0.002). Three groups were analyzed according to the %B/T: ≤40%, 41–59% and ≥60%, observing differences in HbA1c concentrations: 7.1% (6.7–8.0%), 7.8% (7.2–9.1%) and 8.7% (7.6–10.2%), respectively (p=0.003). Regarding microvascular complications, the cases of nephropathy were 0 (0%), 23 (30.7%) and 18 (40%) across those groups (p=0.029) even though there was no difference in T1DM duration across groups. There were also no differences in body mass index, TDD, TDD/weight (units/kg/day), nor in the rates of retinopathy or neuropathy. Multiple regression analysis identified %B/T as an independent predictor of the HbA1c concentration. A difference in the rates of hypoglycemic episodes per month was found among individuals with a %B/T ≤50%: 2 (1–5) versus 6 (2.5–12) episodes per month in those having a higher %BT (p=0.002). There are limitations in our study, including the retrospective nature of the analysis, no data about meal content and a low usage of CGM (thus relying on variable self-monitoring of blood glucose). Therefore, we cannot asseverate that lowering the %B/T would improve glycemic and microvascular outcomes. Nevertheless, our findings indicate that the %B/T correlates with HbA1c levels and are consistent with those previously described. It also suggests a relationship with hypoglycemia and to the best of our knowledge, it is the first time that an association between %B/T and nephropathy has been noted.
    Type of Medium: Online Resource
    ISSN: 2472-1972
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2021
    detail.hit.zdb_id: 2881023-5
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  • 2
    Online Resource
    Online Resource
    The Endocrine Society ; 2023
    In:  Journal of the Endocrine Society Vol. 7, No. Supplement_1 ( 2023-10-05)
    In: Journal of the Endocrine Society, The Endocrine Society, Vol. 7, No. Supplement_1 ( 2023-10-05)
    Abstract: Disclosure: S. Tormo: None. M.S. Kastelic: None. M.V. Forclaz: None. S.A. Varela: None. E. Giacoia: None. Introduction: Advances in medicine in recent decades have increased the survival of pediatric patients with complex chronic pathologies who reach adulthood. Transition refers to the process followed by young persons with chronic conditions to transfer health care, in our case from the pediatric endocrinologist to the adult endocrinologist. It is a dynamic, complex process and must be planned considering medical, psychosocial and educational needs of the adolescent in the change of care that implies an increase in autonomy. ObjectivesPrimary: describe the demographic characteristics of the population that attended the transitional endocrinology clinic. Secondary: evaluate the result of the TRAQ.5.0 survey (Transition readiness assessment questionnaire) in this population. Material and methods Design: observational, cross-sectional and analytical study. The medical records of 155 patients over 15 years old in follow-up for chronic endocrinological diseases in the transition clinic from November 2018 to August 2022, were analyzed. The patients underwent the TRAQ questionnaire validated in Argentina. Statistical Analysis: Quantitative variables are presented with medians and range and qualitative variables with absolute and relative frequencies. The comparisons between the subgroups were made through the Mann Whitney test, considering a p value & lt;0.05 as statistically significant. Results: 155 patients with a median age of 20 years (r:15-30 years) were included. Most were women (61%). 75 % were derived from pediatrics at our hospital. 81% of them attended accompanied. 98% of the patients completed the Questionnaire (TRAQ). No statistically significant changes were found in the TRAQ score according to sex, age and whether the patients were accompanied or not. 79.8 % of the patients stated that they were studying at the time of follow-up, 11% of patients work. 15% (24 patients) were transferred to adult clinics, of which 87% continue follow-up. 80% of non-transferred patients continue follow up. When comparing the TRAQ questionnaire between the transferred patients and those who continue in follow-up, we found significant differences in medication management with a median of 3.6 in the referred group and 3.1 in the follow-up group p: & lt;0.03, and appointment attendance: with a median of 3 in the referred group, 2.3 in the follow-up group (p & lt; 0.01) Conclusions: The goal of the transition is to reduce loss of follow-up and improve the quality of life of patients through an orderly process. We highlight the usefulness of certain tools, such as the TRAQ questionnaire to assess the preparation of patients for the transition. Presentation: Thursday, June 15, 2023
    Type of Medium: Online Resource
    ISSN: 2472-1972
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2023
    detail.hit.zdb_id: 2881023-5
    Location Call Number Limitation Availability
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