733-P: Postprandial Glucose Variability in People with Type 1 Diabetes Is Individual and Impacted by Physiological and Clinical Parameters

Abstract Objectives Our study aims to assess the impact of lockdown during the coronavirus disease 2019 pandemic on glycemic control and psychological well-being in youths with type 1 diabetes. Methods We compared glycemic metrics during lockdown with the same period of 2019. The psychological impact was evaluated with the Test of Anxiety and Depression. Results We analyzed metrics of 117 adolescents (87% on Multiple Daily Injections and 100% were flash glucose monitoring/continuous glucose monitoring users). During the lockdown, we observed an increase of the percentage of time in range (TIR) (p<0.001), with a significant reduction of time in moderate (p=0.002), and severe hypoglycemia (p=0.001), as well as the percentage of time in hyperglycemia (p<0.001). Glucose variability did not differ (p=0.863). The glucose management indicator was lower (p=0.001). 7% of youths reached the threshold-score (≥115) for anxiety and 16% for depression. A higher score was associated with lower TIR [p=0.028, p=0.012]. Conclusions Glycemic control improved during the first lockdown period with respect to the previous year. Symptoms of depression and anxiety were associated with worse glycemic control; future researches are necessary to establish if this improvement is transient and if psychological difficulties will increase during the prolonged pandemic situation.

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The UVA/Padova Type 1 Diabetes Simulator Goes From Single Meal to Single Day

Journal of Diabetes Science and Technology ◽

10.1177/1932296818757747 ◽

2018 ◽

Vol 12 (2) ◽

pp. 273-281 ◽

Cited By ~ 41

Author(s):

Roberto Visentin ◽

Enrique Campos-Náñez ◽

Michele Schiavon ◽

Dayu Lv ◽

Martina Vettoretti ◽

...

Keyword(s):

Type 1 Diabetes ◽

In Silico ◽

Artificial Pancreas ◽

Real Life ◽

Glucose Monitoring ◽

Glucose Variability ◽

Self Monitoring ◽

Inhaled Insulin ◽

Single Meal

Background: A new version of the UVA/Padova Type 1 Diabetes (T1D) Simulator is presented which provides a more realistic testing scenario. The upgrades to the previous simulator, which was accepted by the Food and Drug Administration in 2013, are described. Method: Intraday variability of insulin sensitivity (SI) has been modeled, based on clinical T1D data, accounting for both intra- and intersubject variability of daily SI. Thus, time-varying distributions of both subject’s basal insulin infusion and insulin-to-carbohydrate ratio were calculated and made available to the user. A model of “dawn” phenomenon based on clinical T1D data has been also included. Moreover, the model of subcutaneous insulin delivery has been updated with a recently developed model of commercially available fast-acting insulin analogs. Models of both intradermal and inhaled insulin pharmacokinetics have been included. Finally, new models of error affecting continuous glucose monitoring and self-monitoring of blood glucose devices have been added. Results: One hundred in silico adults, adolescent, and children have been generated according to the above modifications. The new simulator reproduces the intraday glucose variability observed in clinical data, also describing the nocturnal glucose increase, and the simulated insulin profiles reflect real life data. Conclusions: The new modifications introduced in the T1D simulator allow to extend its domain of validity from “single-meal” to “single-day” scenarios, thus enabling a more realistic framework for in silico testing of advanced diabetes technologies including glucose sensors, new insulin molecules and artificial pancreas.

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A Model of Self-Treatment Behavior, Glucose Variability, and Hypoglycemia-Associated Autonomic Failure in Type 1 Diabetes

Journal of Diabetes Science and Technology ◽

10.1177/193229680700100304 ◽

2007 ◽

Vol 1 (3) ◽

pp. 331-337 ◽

Cited By ~ 4

Author(s):

Marc Breton ◽

William L Clarke ◽

Leon Farhy ◽

Boris Kovatchev

Keyword(s):

Type 1 Diabetes ◽

Autonomic Failure ◽

Glucose Variability

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135-OR: Impaired Awareness of Hypoglycemia Is Associated with Residual Beta-Cell Function and Glucose Variability Parameters in Patients with Type 1 Diabetes

Diabetes ◽

10.2337/db21-135-or ◽

2021 ◽

Vol 70 (Supplement 1) ◽

pp. 135-OR

Author(s):

VADIM KLIMONTOV ◽

JULIA F. SEMENOVA ◽

ANTON I. KORBUT

Keyword(s):

Type 1 Diabetes ◽

Beta Cell ◽

Beta Cell Function ◽

Cell Function ◽

Glucose Variability ◽

Impaired Awareness

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Continuous glucose monitoring use and glucose variability in pre-school children with type 1 diabetes

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2018.10.005 ◽

2019 ◽

Vol 147 ◽

pp. 76-80 ◽

Cited By ~ 7

Author(s):

Klemen Dovc ◽

Kevin Cargnelutti ◽

Anze Sturm ◽

Julij Selb ◽

Natasa Bratina ◽

...

Keyword(s):

Type 1 Diabetes ◽

Continuous Glucose Monitoring ◽

School Children ◽

Glucose Monitoring ◽

Glucose Variability

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Effects of Metformin Added to Insulin in Adolescents with Type 1 Diabetes: An Exploratory Crossover Randomized Trial

Journal of Diabetes Research ◽

10.1155/2020/7419345 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Daizhi Yang ◽

Jinhua Yan ◽

Hongrong Deng ◽

Xubin Yang ◽

Sihui Luo ◽

...

Keyword(s):

Body Mass Index ◽

Heart Rate ◽

Heart Rate Variability ◽

Type 1 Diabetes ◽

Insulin Sensitivity ◽

Body Mass ◽

Autonomic Function ◽

Insulin Dose ◽

Glucose Variability

Background. To comprehensively assess the effects of metformin added to insulin on metabolic control, insulin sensitivity, and cardiovascular autonomic function in adolescents with type 1 diabetes. Materials and Methods. This was an exploratory, crossover, randomized trial conducted in adolescents with type 1 diabetes aged 12-18 years old. Participants were randomly received metformin (≤1000 mg/d) added to insulin for 24 weeks followed by insulin monotherapy for a subsequent 24 weeks or vice versa. Blood pressure, body mass index, insulin dose, estimated insulin sensitivity, glycated hemoglobin A1c (HbA1c), and lipid profiles were measured, with a 72-hour continuous glucose monitoring and 24-hour Holter monitoring performed at baseline, 24, and 50 weeks for the assessments of glucose variability and heart rate variability. Results. Seventeen patients with mean ± SD age 14.4 ± 2.3 years , body mass index 18.17 ± 1.81 kg / m 2 , median (IQR) diabetes duration 4.50 (3.58, 6.92) years, and HbA1c 9.0% (8.5%, 9.4%) were enrolled. The between-group difference in HbA1c of 0.28% (95% CI -0.39 to 0.95%) was not significant ( P = 0.40 ). Changes in body mass index, insulin dose, blood pressure, lipid profiles, and estimated insulin sensitivity were similar for metformin add-on vs. insulin monotherapy. Glucose variability also did not differ. Compared with insulin monotherapy, metformin add-on significantly increased multiple heart rate variability parameters. Conclusions. Metformin added to insulin did not improve metabolic control or glucose variability in lean/normal-weight adolescents with type 1 diabetes. However, metformin added to insulin significantly increased heart rate variability, suggesting that metformin might improve cardiovascular autonomic function in this population.

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