904-P: Therapeutic Decisions Based on Interval Analysis of Blood Glucose Curves of Ambulatory Glucose Profile Help Improving Blood Glucose and Glycemic Variability

Background: India is a low-middle income country and cost constraints affect use of emerging technologies in diabetes management. Ambulatory Glucose Profile(AGP) using Libre-pro(Abbott) to assess 14 days ambulatory blood glucose(BG) levels and glucose variability(GV) is used sparingly due to cost concern. Many physicians use interval analysis based on AGP data retrieval at 5-7 days to modify treatment and also evaluate its impact on BG levels at 14 days. However, there is little or no published data on this.

Aim: To assess whether treatment modifications based on interval analysis of daily glucose curves during AGP can improve glucose levels and reduce glucose variability METHOD We analyzed records of 40 type 2 diabetes(T2D) patients(27 men, 13 women, age 17-78 years) who had undergone AGP using Libre-pro and in whom interval analysis of daily BG curves was performed at 7 days. In these patients data was retrieved and analyzed at 7^th day during AGP and treatment was modified based 0-7day data. AGP was continued and complete data was retrieved at 14^th day. Comparison was made for average BG and for time in-, above- and below target range, before and after the 7^th day treatment modifications.

Results: Analysis of AGP records showed a significant reduction in 7-14 days mean BG levels after intervention at 7^th day as compared to 0-7 days mean(152.11±35.29 vs. 173.23±46.4mg/dl, p=0.025). Time in target range increased from 32.33±22.51% to 41.82±21.67% but was not statistically significant(p=0.059). Time above target range decreased significantly from 62.78±25.54% to 50.85±25.86%(p=0.041) while change in time below target range was non-significant(4.97±6.91% vs. 6.62±7.66%, p=0.32).

Conclusion: Treatment decisions based on Interval analysis of AGP data are effective in significantly reducing blood glucose levels and glucose variability in type 2 diabetes patients. Time in range also increased but was statistically not significant.