Difference in impact of flash glucose monitoring in patients with type 1 diabetes mellitus and pancreatogenic diabetes

Buigues Ana Ortola; Valverde Carla Valles; Hoyos Emilia Gomez; Sahagun Rebeca Jimenez; Lopez Gomez Juan Jose; Beatriz Torres; Garcia Esther Delgado; Soto Gonzalo Diaz; Bachiller Beatriz Ramos; Luis Roman Daniel de

doi:10.1530/endoabs.99.EP63

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Endocrine Abstracts (2024) 99 EP63 | DOI: 10.1530/endoabs.99.EP63

ECE2024 Eposter Presentations Diabetes, Obesity, Metabolism and Nutrition (383 abstracts)

Difference in impact of flash glucose monitoring in patients with type 1 diabetes mellitus and pancreatogenic diabetes

Ana Ortolá Buigues ¹ , Carla Valles Valverde ² , Emilia Gómez Hoyos ¹ , Rebeca Jiménez Sahagún ¹ , Juan José López Gómez ¹ , Beatriz Torres Torres ¹ , Esther Delgado García ¹ , Gonzalo Díaz Soto ¹ , Beatriz Ramos Bachiller ¹ & Daniel de Luis Román ¹

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¹Hospital Clínico Universitario Valladolid; ²Facultad de Medicina. Universidad de Valladolid

Introduction: Diabetes mellitus secondary to exocrine pancreas diseases (pancreatogenic DM) is a heterogeneous type of DM that usually requires treatment with multiple doses of insulin (MDI), like type 1 DM (DM1). Our objective was to evaluate the difference in the impact of Flash glucose monitoring (FGM) on glycemic control in pancreatogenic DM and DM1.

Methods: Prospective, observational study in Spanish hospital. We included the first patients with DM1 who started FGM from June 2019 to April 2020 and patients with pancretogenic DM from January 2021 to June 2023, all on treatment with MDI. Patient data collected included demographic, clinical, anthropometric variables, as well as etiology, duration and treatment of DM. In addition, blood glucose control variables from the Abbott FreeStyle Libre the first 14 days and at 3 months were recorded: glucose management indicator (GMI), coefficient of variation (CV), percentage of time in range (TIR) (70-180 mg/dl), and hypoglycaemic events in 14 days.

Results: 86 patients with DM1 vs 26 patients with pancreatogenic DM were included. Of DM1 61.6% were male vs 50% in pancreatogenic DM (P=0.291). Their age was 37.4 (SD 13.0) vs 59.7 (SD 16.4) years (P<0.001). DM duration was 18.1 (SD 11.3) vs 8.8 (SD 6.8) years (P<0.001). Total insulin dose/kg/day at the first visit was 0.62 (SD 0.20) vs 0.52 (SD 0.29) IU/kg/day (P=0.045). Of the pancreatogenic DM, 53.8% were secondary to pancreatectomy (26.9% total and 26.9% partial), and 30.8% due to chronic pancreatitis. In the first 2 weeks of FGM, there were no significant differences in the number of scans, TIR or GMI, in the two types of DM. There was a significant higher CV in DM1 patients [41.3 (SD 7.4) vs 31.7 (SD 5.7) P<0.001] and hypoglycemia events [13.5 (SD 9.1) vs 2.5 (SD 2.9) P<0.001] and their duration [95.7 (SD 44.9) vs 56.8 (SD 56.3) min, P<0.001]. At 3 months, there were only improvements in DM1 glucometry in decrease of hypoglycemia events [10.7 (SD 6.7) vs 13.5 (SD 9.1) P=0.001], with no changes in pancreatogenic DM. Regarding treatment, there was no change at 3 months in DM1, while in pancreatogenic DM an increase in bolus insulin use was observed [13.9 (SD 9.5) vs 11.0 (SD 7.1) IU/day, P=0.009], with no change in basal insulin.

Conclusion: Pancreatogenic DM patients have lower risk of hypoglycemia than DM1 patients, and the decrease in hypoglycemia events described in DM1s with GMF is not observed in them.