PO-0068 Improving Metabolic Memory With Intensive Early Management In Newly Diagnosed Type 1 Diabetes Is A Foundation To Improve Short And Long Term Control

Abstract

Objective To demonstrate variations in HbA1C (glycosylated haemoglobin) levels between two paediatric cohorts with different approach in diabetes management in blood glucose monitoring (routine and intense) and insulin administration. Design A follow up cohort study of 34 children and adolescents in a large district hospital with diagnosis of Type 1 diabetes between 2005 and 2011. Results In the first group (G1=14), without intensive blood sugar monitoring, mean HbA1Cpost diagnosis was 8.67% (95% CI 7.87–9.48%).11 out of 14(79%) of them had HbA1C above target level (7.5%). In the second group (G2=20) with intensive monitoring, mean HbA1Cpost diagnosis was 7.87% (95% CI 7.29–8.44%). 12 out of 20 (60%) had HbA1C above target level (7.5%) Table 1 G1a/b: Group without intensive initial monitoring’2005/12 G2a/b: Group with intensive initial monitoring’2011/12 Abstract PO-0068 Table 1 Mean HbA post diagnosis quarter (95% CI) HbA >7.5% (Numbers/%) Reduction of HbA levels achieved (%) G1a 8.67(7.87–9.48) 11(79) 21 G1b 10.45(9.10–11.81) 13(93) 7 G2a 7.87(7.29–8.44) 12(60) 40 G2b 7.81(7.33–8.29) 13(65) 35 Abstract PO-0068 Table 2 HbA trends (%) 95% CI (%) G1(a vs. b) +1.78 0.24–3.32 G2(a vs. b) -0.06 0.52–0.40 CI-Confidence Interval Conclusions No significant difference of HbA in two groups post diagnosis; mean HbA1C level (p = 0.082). Comparing the changes over time in the two groups, an increase of HbA1C of 1.78 (Table2) percentage points in G1 (without intensive monitoring) was significantly greater than the decrease of 0.06 percentage points in G2 (p = 0.008). Discussion Intensive initial management of type 1 Diabetes can significantly reduce future HbA1C. We aim to follow G2 over next 5 years to establish that an improved metabolic memorycould reduce HbA1C levels over longer periods.