CLINICAL CHARACTERISTICS, GLYCAEMIC CONTROL AND HYPOGLYCAEMIA EVENTS AMONG TYPE 1 DIABETES PATIENTS USING CONTINUOUS GLUCOSE MONITORING SYSTEMS IN HTAA

Abstract

INTRODUCTION
The incidence of T1D in Asia is approximately 2-5 per 100,000 person-year. Hypoglycaemia is common among patients with T1D and a number of T1D patients are asymptomatic for hypoglycaemia. Continuous glucose monitoring systems appear to be a useful tool in detecting hypoglycaemia events.

METHODOLOGY
We conducted a retrospective audit of the medical records of 26 patients diagnosed with T1D consulting at the diabetes clinic at Hospital Tengku Ampuan Afzan (HTAA) from January 1, 2021 until December 31, 2021. Demographic data, anthropometric measurements, and biochemical data were collected. The number of events and duration of hypoglycaemia for patients with CGMS data using Flash Libre™ system were analysed. All data were presented in median and interquartile ranges.

RESULTS
Twenty six (26) patients with T1D were analysed. Most of them were Malay, 69.3% were female and the median age was 27 years old (23-35 years old). Mean age at diagnosis was 19 years old (15-25 years old). Average HBA1c was suboptimal at 9.65% (8.4%-12.2%). Total daily dose (TDD) of insulin used was 37.5 units/day (30-44) and 0.68 units/kg/day (0.54-0.77). Among patients with T1D, five subjects had CGMS. The median number of hypoglycaemia events was 11 (5.5-11.5) in fourteen days and the duration of hypoglycaemia events was 102 minutes (80-183).

CONCLUSION
In our cohort, the median HBA1c was similar to the national average (10.8%). However, the number of hypoglycaemia events documented via CGMS was high. This could be explained by the high TDD of insulin used. Higher TDD of insulin might have contributed to hypoglycaemia leading to defensive eating which resulted in hyperglycaemia. The study was limited by the number of patients with CGMS due to limited acceptance of CGMS by the patients. CGMS should be recommended to all T1D patients who are known to have a higher risk of hypoglycaemia.