274-OR: Association between Continuous Glucose Monitoring–Derived Metrics and Diabetes Complications—Data from People with Type 1 Diabetes in Saudi Arabia

Introduction and Objective: Continuous glucose monitors (CGMs) are the standard of care for people with type 1 diabetes (PWT1D), yet studies linking CGM metrics with diabetes complications in PWT1D are scarce. We examined the association between CGM metrics and microvascular complications in PWT1D in Saudi Arabia. Methods: We analyzed CGM data and medical records of 253 PWT1D at two Saudi tertiary diabetes centers. We included PWT1D who had retinal exams, one-month CGM data within 3 months of the retinal exam, and sensor active time ≥70%. Risk factors of diabetic retinopathy (DR), albuminuria, and a composite microvascular complication (CMC) of DR and/or albuminuria were evaluated using multivariable logistic regression. Results: Those with TIR>80% had lower rates of DR (0% vs 26.9%, p=0.02), albuminuria (7.7% vs 20%, p=0.27), and CMC (7.7% vs 40.7%, p=.02) than those with TIR≤80. Likewise, PWT1D with TIR>50% had lower rates of DR (20.2% vs 29.9%, p=0.08), albuminuria (11.5% vs 25.8%, p<0.01), and CMC (31.1% vs 45.3%, p=.03) than those with TIR≤50%. Increasing glycemia risk index (GRI) levels (0-20, 21-60, >60) corresponded with higher prevalence of DR (0, 24.2, and 28.1%, p=0.09), albuminuria (11.1, 10.7, and 25.2%, p=0.03), and CMC (11.1, 33.3, and 44.2%, p=0.06). Duration of diabetes ≥10 years, TIR≤60%, and SBP>126 mmHg were significant predictors of retinopathy after adjusting for age, gender, duration of diabetes, CGM CV, TIR, hemoglobin A1C, systolic blood pressure (SBP), triglycerides, and HDL when appropriate. The only significant predictors of albuminuria in the adjusted model were duration of diabetes ≥10 years, SBP>126 mmHg, and TG>1.22. Hemoglobin A1C was not associated with any microvascular complications in the adjusted model. Conclusion: Our findings support the association between microvascular complications and lower TIR, longer diabetes duration, and higher GRI, SBP, and TG in PWT1D in Saudi Arabia Disclosure M. Al-Sofiani: Advisory Panel; Medtronic. Speaker's Bureau; Insulet Corporation, Abbott, Lilly Diabetes. Advisory Panel; Dexcom, Inc., Roche Diabetes Care. Speaker's Bureau; Sanofi. Research Support; Medtronic. Speaker's Bureau; Vitalaire. A.M. Shadid: None. A. Shadid: None. M. Makkawi: None. A.B. Albacker: None. O. Aldosari: None. R.J. Alshareef: None.