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. 2023 Mar;33(3):631-639.
doi: 10.1016/j.numecd.2022.11.008. Epub 2022 Nov 17.

A sub-analysis of the SAGE study in Italy indicates good glycemic control in type 1 diabetes

D Bruttomesso  1 , C Irace  2 , P Pozzilli  3 ; SAGE study group
Collaborators, Affiliations
Free article

A sub-analysis of the SAGE study in Italy indicates good glycemic control in type 1 diabetes

D Bruttomesso et al. Nutr Metab Cardiovasc Dis. 2023 Mar.
Free article

Abstract

Background and aims: Intensive glycemic control minimizes the risk of micro- and macrovascular complications in patients with type 1 diabetes (T1D). We report glycemic control in Italian participants (age groups: 26-44, 45-64, and ≥65 years) of the global SAGE study.

Methods and results: The primary endpoint was proportion of participants who achieved an HbA1c <7% in predefined age groups. In the 523 patients with T1D, mean age was 44.6 years and mean body mass index (BMI) was 25 kg/m2. Mean HbA1c was 7.5% and 29.4% had HbA1c <7.0%, with the highest percentage in those 26-45 years (31.7%) and the lowest in those ≥65 years (20%). Altogether, 22.9% of patients achieved their physician-established individualized HbA1c target. Most patients had ≥1 symptomatic hypoglycemic episode in the previous 3 months (≤70 mg/dL 82.5%; ≤54 mg/dL 61%). Severe hypo- and hyperglycemia were experienced by 16.3% and 12% of patients, of which 7.1 and 9.5%, respectively, required hospitalization/emergency visits. More patients achieved HbA1c <7% with CSII (30%) than with multiple daily insulin injections (27.9%). In multivariate analysis, BMI (OR 0.94, 95% CI 0.89-0.99, p = 0.032) and adherence to diet (OR 0.36, 95% CI 0.18-0.70, p = 0.0028) were significantly associated with HbA1c <7.0%.

Conclusions: Glycemic control can be considered good in the Italian SAGE cohort, especially in younger patients, who more frequently use pumps/continuous glucose monitoring. Greater patient education and use of technology may further support this achievement. Patients should be encouraged to maintain a low BMI and adhere to their diet.

Keywords: Glycemic control; SAGE (Study of adults' GlycEmia); Type 1 diabetes.

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Conflict of interest statement

Declaration of competing interest DB has provided advisory board services for served as a consultant or speaker for Abbott, AstraZeneca, Sanofi and has received speaker fees for Abbott, Eli Lilly, Novo Nordisk, Roche Diagnostics and Sanofi. CI has provided advisory board services for Novo Nordisk, Lilly, Abbott, Menarini, Roche Diabetes Care, and Ascensia, and has received speaker fees for Novo Nordisk, Abbott, Senseonics, Lilly, and Boehringer Ingelheim Pharmaceuticals. GP has provided advisory board services for Dompè, speaker fees for Eli Lilly, Grant Recipient for Amgen Inc, Sanofi, Dompè, Abbott, Novo Nordisk, consulting fee from AstraZeneca, Sanofi, Eli Lilly, Enthera.

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