Objectives: Describe Mexican patients with T1DM and find out if blood glucose (BG) testing frequency impacts glycemic targets (mean BG & estimated HbA1c eHbA1c).
Methods: Included mySugr users with a ...self-reported diagnosis of T1DM and had at least 2 BG logs in at least 14 days (G2D14) in the month prior to their first log entry. G2D14 is the lowest adherence needed to calculate eHbA1c. Users were stratified as low (G2D14 + G3D14) and high testing (G4D14 + G5D14). Subgroup analysis according to baseline eHbA1c was performed. Using a logistic regression model, an exploratory analysis to identify factors associated with BG decrease was also considered.
Results: 118,210 users (13% T1DM) were considered. Users in the highest testing subgroup (G5D14; n=276) in the first month before mySugr usage had a significantly lower baseline eHbA1c (-0.8 %; p < 0.01) compared with users in the lowest category (G2D14; n=254). For all users in the group G2D14 or above, eHbA1c decreased from baseline (1 mo. prior to mySugr usage) and stayed below baseline levels for the entire period of 5 mo. (n=253; mean differences: -0.3% at the first month of mySugr usage, -0.2% at the fourth month of mySugr usage; both changes significantly different from 0 with p < 0.05). No statistically significant difference in eHbA1c between the logging subgroups after 4 months of mySugr use was found. Nevertheless, high logging users with baseline eHbA1c > 8% had a non-significant higher reduction. In the logistic regression model, the factor with the strongest association with BG decrease was the baseline mean BG (log OR: 2.4).
Conclusion: in our RwD setting, the use of mySugr was associated with reduced eHbA1c. Baseline BG was statistically associated with BG reduction intensity. Although no significant difference in eHbA1c improvement between the high and low logging groups was found during mySugr usage, the baseline analysis suggests that users with increased logging had significantly better glycemic control before starting mySugr.
Disclosure
C. Vulcano: Employee; Roche Diabetes Care. H. Mikulski: Employee; Roche Diabetes Care. M. Mitter: Employee; Roche Diabetes Care. B. Ruch: Employee; Roche Diabetes Care.
Category:
Midfoot/Forefoot; Trauma
Introduction/Purpose:
Several different types of 5th metatarsal fractures exist and are treated with various methods of immobilization, weight bearing restrictions, ...and occasionally operative procedures. The purpose of this study was to evaluate the differences in clinical and radiographic outcomes between pseudo-Jones fractures (Zones 1 and 2 of the 5th MT base), True Jones fractures (Zone 3), and 5th MT shaft fractures.
Methods:
This was a retrospective cohort study of patients presenting to a single large, urban, academic medical center with any 5th MT fracture between 2012 and 2022. Inclusion criteria for this analysis included patient follow up until there was evidence of radiographic healing, clinical healing, or duration greater than one year following injury. Radiographs obtained at the initial presentation were reviewed and fracture patterns were categorized as either Zone 1, Zone 2, Zone 3, or Shaft. Linear regression models were used to evaluate the effect of fracture type on the duration of healing when controlling for age, sex, BMI, smoking status, and history of diabetes.
1,279 patients with 5th metatarsal fracture met the inclusion criteria and were included in the analysis (mean age 49.2 +/- 17.9 years). Overall, 5.2% were treated in a splint or cast, 67.5% in a CAM boot, 20.3% in a hard sole shoe, and 7.0% without immobilization.
Results:
31.2% of patients were non-weight bearing, 8.1% partial weight bearing, and 60.7% weight bearing as tolerated. There was no difference in time to radiographic union (p=0.946) or time to clinical healing (p=0.520) between any of the fracture types. Similarly, there was no difference in the proportion of patients with incomplete radiographic healing at 6 months (p=0.310) and at 1 year after injury (p=0.552) based on the fracture type. Likewise, there was no difference in any clinical or radiographic healing parameter based on fracture type for patients treated operatively. Based on linear regression model, there was no difference in the time to clinical or radiographic healing when controlling for confounding factors.
Conclusion:
All commonly occurring 5th metatarsal fractures, including those of both the metatarsal base and the shaft, demonstrate similar times to clinical and radiographic healing.
