677-P: Bioimpedance Phase Angle in Diabetes and Change after an Interdisciplinary Care and Diabetes Self-Management Education Program

Bioimpedance phase angle (PA) is an index of cellular health and function, and a high PA suggest better cellular membrane integrity and a higher cell mass. PA has been identified as a valuable measurement for the diagnosis, monitoring and prognosis of various disorders. We evaluated baseline differences and change in PA in patients who attended a five months Interdisciplinary Care and Diabetes Self-management Education Program in a public primary care specialized diabetes clinic in Mexico City/Iztapalapa in 2018. In 327 persons with type 2 diabetes, PA was evaluated by bioelectrical impedance multifrequency analysis (Seca® 515/514, 50 Hz). Diabetes-related microvascular complications (MiVC) were defined by fundoscopy with mydriatic camera assessed by an ophthalmologist (retinopathy) and increased urine albumin/creatinine ratio and/or decreased estimated glomerular filtration rate (diabetic kidney disease). Women represented 67% and 56% had elementary or less education. Mean age was 55±10 years old, mean duration of diabetes was 12±8 years, 32.7% presented nephropathy and 24.8% retinopathy. Baseline PA was different among participants with or without MiVC (4.66±0.65 vs. 5.02±0.58, p<0.0001). Change in PA was different among participants with non-MiVC (5.02±0.58 to 5.11±0.62, p=<0.0001) but not among participants with MiVC (4.66±0.65 to 4.62±0.65, p=0.136) after the program. Diet self-care behavior improvement (2.6± 1.6 to 5.4±0.9 days/week, p=<0.001) and HbA1c reduction (9.45±2.0 to 6.7±1.2%, p=<0.001) were also observed with no differences among groups. Baseline PA was different according to the MiVC profile implying its prognosis and diagnosis role. PA improvement in persons with diabetes and absence of MiVC suggest a monitoring role of PA, but also suggest an added effect and the efficacy of this program since it favors the achievement of multiple diabetes care goals, that could be being reflected in PA as a marker of cellular integrity.