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A significant portion of pregnant women with Gestational Diabetes Mellitus (GDM) eventually requires insulin therapy, thus necessitating closer monitoring. In this study, we assessed a predictive model for the need of insulin therapy in women with GDM. In a retrospective cohort study, baseline data from 246 women with GDM (43% on subsequent insulin therapy, 57% on nutritional therapy alone) were analyzed using logistic regression. Diagnosis of GDM in previous pregnancies, previous GDM managed with insulin therapy, previous maternal impaired fasting glucose, fasting serum glucose diagnostic for GDM, and 0h and 2h diagnostic values at 75-g oral glucose tolerance test were independent qualitative significant predictors for subsequent insulin therapy. Pre-conceptional maternal body mass index, fasting serum glucose, HbA1c and gestational age at GDM diagnosis were independent quantitative significant predictors for subsequent insulin therapy. According to the odds ratios produced by the logistic regression, a risk score was developed, with identification of low (score Disclosure M.Caporusso: Other Relationship; Eli Lilly and Company. L.Di gioia: Other Relationship; Eli Lilly and Company, Menarini Group. G.Sorice: None. A.Cignarelli: None. A.Natalicchio: Consultant; Novo Nordisk, Other Relationship; AstraZeneca, Lilly Diabetes, Sanofi. F.Giorgino: Advisory Panel; AstraZeneca, Boehringer Ingelheim International GmbH, Novo Nordisk, Consultant; Lilly Diabetes, Sanofi, Research Support; Lilly Diabetes, Roche Diabetes Care, Takeda Pharmaceutical Company Limited. L.Laviola: Advisory Panel; Lilly Diabetes, Novo Nordisk, Roche Diabetes Care, Sanofi, Speaker's Bureau; A. Menarini Diagnostics, Abbott Diabetes, Medtronic, Terumo Corporation.

Bariatric surgery and consequent weight loss improve metabolic and anthropometric parameters in obese subjects. However, a detailed assessments about the impact of bariatric surgery on quality of life (QoL), body image perception, and sex life is lacking. The aim of this study was to assess the QoL, body image satisfaction and sexual function in 389 female patients with obesity (age 40±10 years, pre-surgery weight 120.4±17.7 kg) before and at least 6 months after bariatric surgery (60% sleeve gastrectomy, 40% gastric bypass). All participants were asked to complete the following online self-report questionnaires seven days before and six months after bariatric surgery: the Body Uneasiness Test (BUT) to assess self-perception of body image, the Short Form-12 (SF-12) to QoL as per the physical (PCS) and mental (MCS) domains, and the Female Sexual Function Index (FSFI) to screen for sexual dysfunctions in women. After bariatric surgery, patients lost 44.5±16.5 kg (p Disclosure L. Di gioia: None. A. Natalicchio: Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Lilly Diabetes, Sanofi. L. Laviola: Advisory Panel; Self; A. Menarini Diagnostics, Abbott, AstraZeneca, Lilly Diabetes, Novo Nordisk Inc., Roche Diabetes Care, Sanofi-Aventis, Speaker’s Bureau; Self; Boehringer Ingelheim International GmbH, Medtronic. A. Bertolino: None. F. Giorgino: Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Lilly Diabetes, Novo Nordisk, Roche Diabetes Care, Sanofi, Research Support; Self; Lilly Diabetes, Roche Diabetes Care. S. Perrini: None. A. Braun: None. E. Rossi: None. F. Giordano: None. F. Guarini: None. E. Siciliano: None. A. Cignarelli: None. A. Leonardini: None.

Irisin is a hormone secreted by skeletal muscle following physical activity or excess of saturated fatty acids, able to promote energy expenditure and improve metabolic homeostasis. Serum irisin levels are reduced in type 2 diabetes (T2D), while exogenous irisin administration improves glycemic control in diabetic mice. We have previously demonstrated that irisin promotes beta-cell viability and insulin secretory function. This study investigated serum irisin levels in T2D patients according to their antidiabetes treatment. 127 T2D patients were enrolled and stratified by antidiabetes therapy: diet only (17); metformin only (met, 37); met plus sulfonylureas (5); met plus pioglitazone (7); met plus GLP-1 receptor agonists (GLP-1RAs, 31); met plus DPP-4 inhibitors (DPP-4i, 15); and met plus SGLT2 inhibitors (SGLT2i, 15). The control group included 36 sex-, and BMI-matched subjects without diabetes. T2D patients showed lower irisin levels than controls (21.5 [10.1-50.8] vs. 29.1 [14.1-43.5] ng/mL, P In conclusion, in T2D GLP-1-based therapies significantly increase serum irisin to levels comparable to those of nondiabetic subjects, possibly through GLP-1 receptor-mediated stimulation of irisin release by skeletal muscle cells. Irisin may thus represent a new factor in the mechanism of action of GLP-1-based therapies. Disclosure A. Natalicchio: Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Lilly Diabetes, Sanofi. S. Perrini: None. L. Laviola: Advisory Panel; Self; A. Menarini Diagnostics, Abbott, AstraZeneca, Lilly Diabetes, Novo Nordisk Inc., Roche Diabetes Care, Sanofi-Aventis, Speaker’s Bureau; Self; Boehringer Ingelheim International GmbH, Medtronic. F. Giorgino: Consultant; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Lilly Diabetes, Novo Nordisk, Roche Diabetes Care, Sanofi, Research Support; Self; Lilly Diabetes, Roche Diabetes Care. N. Marrano: None. G. Biondi: None. A. Montedoro: None. G. Le grazie: None. L. Di gioia: None. F. Guarini: None. A. Borrelli: None. A. Cignarelli: None. Funding European Union–European Social Fund; PON R&I (2014-2020); AIM (1810057)

Physical exercise may profoundly affect glucose variability (GV) in insulinopenic diabetes leading to both hypo- and hyperglycemia and feeling of discomfort reported by the patients after work out. Even if combined training reportedly reduces GV, an ideal training protocol is still not established in these patients. The aim of this study was to evaluate the effects of different combinations of continuous aerobic exercise (CON) and high intensity interval training (HIIT) on GV during a 24-h period after work out. A cross-over study was conducted on 14 outpatients [male 50%, mean age 31.9 (8.1) y, BMI 22.1 (2.5) Kg/m2] with either T1D (n=10) or LADA (n=4) on continuous subcutaneous insulin infusion (CSII) therapy [4 (3.9) y]. Data from flash glucose monitoring were collected for 72 h before work out. After different sequences of HIIT and CON work out (HIIT followed by CON, HIIT-CON; and CON followed by HIIT, CON-HIIT), 24-h glucose profiles were acquired. Several indices of GV and predictors of hypo-/hyperglycemia were analyzed. Indices of GV revealed no statistically significant difference when compared to baseline GV [mean -0.38 (1.85) vs. -0.43 (1.66); SD 0.02 (1.06) vs. -0.04 (0.94); CONGA: -0.18 (1.63) vs. -0.36 (1.69); MAG -0.12 (0.44) vs. -0.21 (0.47); MAGE 0.73 (1.65) vs. 1.11 (0.84); LBGI: 1.28 (6.83) vs. 1.71 (5.43); HBGI -0.18 (5.34) vs. -1.03 (4.89); HIIT-CON delta vs. baseline and CON-HIIT delta vs. baseline, respectively]. Moreover, time spent in 180 mg/dl 24 h after either HIIT-CON or CON-HIIT training was comparable to baseline [for 180 mg/dl: baseline 27.2% (22.7), HIIT-CON 22.6% (21.1), CON-HIIT 22.2% (16.8)]. The comparison between HIIT-CON and CON-HIIT also showed no differences in GV. Thus, a standardized combined work out (either HIIT-CON or CON-HIIT) avoids late glycemic fluctuations and dangerous hypo-/hyperglycemia in T1D and LADA patients on CSII therapy. Disclosure A. Cignarelli: Consultant; Self; Eli Lilly and Company. Speaker's Bureau; Self; Merck Sharp & Dohme Corp., Novo Nordisk A/S. G. Lisco: None. L. Di Gioia: None. A. Natalicchio: Other Relationship; Self; Novo Nordisk Inc., Sanofi-Aventis. S. Perrini: None. L. Laviola: Advisory Panel; Self; Abbott, Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes, Novo Nordisk Inc. Board Member; Self; AstraZeneca, Roche Diabetes Care, Sanofi-Aventis. Speaker's Bureau; Self; Medtronic, Mundipharma, Takeda Pharmaceutical Company Limited. F. Giorgino: Advisory Panel; Self; Aegerion Pharmaceuticals, AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, MedImmune, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Roche Diabetes Care, Sanofi. Consultant; Self; Roche Diabetes Care, Sanofi. Research Support; Self; Eli Lilly and Company, LifeScan, Inc., Takeda Pharmaceutical Company Limited. Other Relationship; Self; AstraZeneca, Eli Lilly and Company, Sanofi.

IntroductionFlash glucose monitoring (FGM) is a factory-calibrated sensor-based technology for the measurement of interstitial glucose. We performed a systematic review and meta-analysis to assess its efficacy and safety in patients with type 1 and type 2 diabetes.Research design and methodsPubMed, CENTRAL, Scopus and Web of Science were searched in July 2019. Twelve studies with a follow-up longer than 8 weeks, evaluating 2173 patients on prandial insulin, multiple daily insulin injections or continuous subcutaneous insulin infusion were included. The following data were extracted: HbA1c, time in range, time above 180 mg/dL, time below 70 mg/dL, frequency of hypoglycemic events, number of self-monitoring of blood glucose (SMBG) measurements, total daily insulin dose, patient-reported outcomes, adverse events, and discontinuation rate. A comparison with SMBG was conducted.ResultsFGM use was associated with a reduction in HbA1c (−0.26% (−3 mmol/mol); p=0.002) from baseline to the last available follow-up, which correlated with HbA1c levels at baseline (−0.4% (−4 mmol/mol) for each 1.0% (11 mmol/mol) of HbA1c above 7.2% (55 mmol/mol)). Also, a decrease in time below 70 mg/dL was found (−0.60 hours/day; p=0.04). Favorable findings in patient-reported outcomes and no device-related serious adverse events were reported. When compared with SMBG, FGM was characterized by no statistically different change in HbA1c (p=0.09), with lower number of SMBG measurements per day (−3.76 n/day; pConclusionsThe present review provides evidence for the use of FGM as an effective strategy for the management of diabetes.