P975 - INFLUENCE OF ARTIFICIAL NUTRITION ON GLYCEMIC VARIABILITY IN DIABETIC PATIENTS.

P975

INFLUENCE OF ARTIFICIAL NUTRITION ON GLYCEMIC VARIABILITY IN DIABETIC PATIENTS.

A. DEPRADE¹, P. FAYEMENDY^2,3, T. Vernier^2,3, L. SALLE^1,3, P. JESUS^2,3,*

¹endocrinology, diabetology, ²Nutrition Unit, University hospital of Limoges, ³U1094 Inserm, U270 IRD, Epidemiology of Chronic Diseases in Tropical Area (EpiMaCT), University of Limoges, limoges, France

Rationale:  

The literature suggests that the measurement of glycemic variability (CV : coefficient of variation) in diabetic patients is a promising predictive biomarker of cardiovascular morbidity and mortality. However, its evolution during artificial nutrition has never been described, despite the fact that artificial nutrition causes glycemic imbalance, making the adjustment of antidiabetic therapies complex. Our objectives were i) to study the evolution of CV after the introduction of artificial nutrition in diabetic patients and ii) to search for factors associated with CV.

Methods: We conducted a retrospective study of 43 diabetic patients followed in 2021 in a Nutrition Unit. Glycemic and anthropometric data were collected before and at the initiation of enteral (NE) and parenteral (NP) nutrition, as well as the type of anti-diabetic treatment. CV calculation was based on spot capillary glucose levels. Statistical analysis included Student's t-test, Chi 2 and multivariate logistic regression.

Results: Patient age was 67.5 ± 10.2 years, with 71.7% men. BMI before nutritional support was 23.5 ± 4.9 kg/m2 with 72.5% malnourished. 76.1% of patients had NE and 11% NP. 67.4% received cyclic nocturnal nutrition, with a passage time of 12.1 ± 3.3 h and a carbohydrate output of 235 ± 92.8 mg/h. CV increased from 18.7% to 27.2% during artificial nutrition (p=0.0005). Respectively, during NE and NP, CV increased from 18.7% to 23.2% (p=0.009) and from 17.5% to 36.5% (p=0.005). In multivariate analysis, increasing insulin dose was positively associated with a decrease in CV (OR=1.01 [1.01-1.02], p=0.048).

Conclusion: Our study showed an increase in glycemic variability when artificial nutrition was introduced, whatever the initial treatment. Adaptation of insulin dose seems to be a major factor in glycemic variability during artificial nutrition.

Disclosure of Interest: None declared