Endocrine Abstracts

JOINT1702

Introduction: Alterations in body composition, such as reduced lean mass and increased adiposity, may negatively influence insulin sensitivity, glycemic control, and contribute to cardio-metabolic risk in patients with type 1 diabetes (T1D). These changes may result from insulin therapy, inadequate eating patterns, physical inactivity, or inflammatory processes associated with the disease. Understanding the interplay between T1D, body composition and metabolic parameters may help optimizing patient care. This study aimed to investigate the relationships between body composition parameters, clinical characteristics and glycemic control in a cohort of Italian adult patients with T1D.

Methods: This cross-sectional study included 94 patients with T1D (mean age ± standard deviation 43 ± 15 years); 58.5/41.5% males/females) with mean disease duration of 16 years (range 10-27), mean body mass index 24.6 kg/m² (21.8-27.7). Body composition was assessed using bioelectrical impedance analysis, measuring fat mass (FM), fat-free mass (FFM), skeletal muscle mass (SMM), sarcopenic index (SI), and phase angle (PA). Glycemic control was evaluated using continuous or flash glucose monitoring systems-derived metrics. Clinical data included diabetes-related complications, and patients’ comorbidities and concomitant medications. Daily insulin requirements were also calculated.

Results: Correlation analysis showed significant associations between disease duration and FFM (r = -0.21, P = 0.0382), SMM (r = -0.31, P = 0.0024), and SI (r = -0.28, P = 0.0064). Daily insulin requirements positively correlated with FM (r = 0.29, P = 0.0047). PA was inversely associated with glucose management indicator (GMI r = -0.22, P = 0.0482), while positively correlated with time in range (TIR r = 0.22, P = 0.0436). Gender analysis revealed that females had significantly higher FM, and lower of FFM, SMM, SI, and PA values compared with males.

Conclusions: These finding suggests that long-standing T1D negatively affects muscle-mass measures. Moreover, poor glycemic control can negatively influence PA, a marker of cellular health, which has been associated with adverse clinical outcomes in several pathological conditions, including cancer, infections, and metabolic diseases. Furthermore, the positive relationship between FM and daily insulin requirements emphasizes the role of body fat in insulin resistance. Therefore, our study suggests the importance of monitoring and optimizing body composition as part of the comprehensive management of T1D. Significant gender-specific differences in body composition also highlight the need for personalized therapeutic strategies. Further research is needed to clarify the mechanisms underlying these relationships and their implications for clinical care in T1D patients.