ABSTRACT Objective: To evaluate glycemic control according to the number of daily basal rates (BRs) in type 1 diabetes patients using continuous subcutaneous insulin infusion (CSII). Subjects and methods: Cross-sectional study of patients treated with an open-loop CSII for at least 6 months and using a flash glucose monitoring system. Patients were divided into 2 groups: group 1 (G1) and group 2 (G2), with ≤4 and >4 BRs/24h, respectively. The groups were compared regarding HbA1c, time in range (TIR), time above range (TAR), time below range (TBR), glucose management indicator (GMI), glucose variability and data related to hypoglycemia. Regression models were performed. Results: The study included 99 patients (n = 55 in G1; n = 44 in G2). Median (Interquartile range) overall age was 30 (17) years, with 19.5 (48) and 51 (77) months of CSII use, respectively. The median number of different BRs was 3 (2) for G1 and 6 (2) for G2. There were no differences concerning age, sex, educational stage, weight, and insulin analog used. G2 had longer disease duration, longer CSII use, and higher total basal daily dose/kg. No significant differences regarding HbA1c, median glucose, GMI, TIR, TAR, and CV were found. G2 patients had more hypoglycemia, more asymptomatic hypoglycemia, and higher TBR. After adjusting for potential confounders, G1 maintained a lower risk of asymptomatic hypoglycemia. Conclusion: Programming open-loop CSII devices with more than 4 BRs does not improve metabolic control. Additionally, it seems to be a risk factor for hypoglycemia and was an independent predictor for asymptomatic hypoglycemia. Objective (BRs CSII. . (CSII) methods Crosssectional Cross sectional openloop open loop system G (G1 G2, , (G2) ≤ > BRs24h BRsh 24h h BRs/24h respectively HbA1c HbAc HbA c TIR (TIR) TAR (TAR) TBR, TBR (TBR) GMI (GMI) performed Results 9 5 G2) Interquartile 17 (17 years 195 19 19. 48 (48 77 (77 use (2 sex stage weight used duration dosekg dose kg dose/kg found confounders Conclusion Additionally (CSII (G (G2 (TIR (TAR (TBR (GMI (1 (4 7 (7 (

ABSTRACT Objective This study aimed to evaluate the association of detectable C-peptide levels with various continuous glucose monitoring (CGM) metrics and diabetes complications in patients with type 1 diabetes mellitus (T1DM). Subjects and methods Retrospective, descriptive study of 112 patients with T1DM undergoing intensive insulin therapy, categorized according to fasting C-peptide level into undetectable (<0.05 ng/mL) and detectable (≥0.05 ng/mL) groups. Results The patients’ median age at diagnosis was 22 (12-34) years and the median T1DM duration was 18.5 (12-29) years. Patients with detectable versus undetectable C-peptide levels were older (27.5 [16.5-38.5] versus 17.5 [9.8-28.8] years, respectively, p = 0.002) and had shorter disease duration (14 [9-24] versus 20 [14-32] years, respectively, p = 0.004). After adjustment for covariates (sex, disease duration, body mass index, and use of continuous subcutaneous insulin infusion), detectable C-peptide level was associated with lower time above range (TAR; aβ -11.03, p = 0.002), glucose management indicator (GMI, aβ -0.55, p = 0.024), and average glucose (aβ -14.48, p = 0.045) and HbA1c (aβ -0.41, p = 0.035) levels. Patients with detectable versus those with undetectable C-peptide level had significantly higher time in range (TIR) before (β = 7.13, p = 0.044) and after (aβ = 11.42, p = 0.001) adjustments. Detectable C-peptide level was not associated with lower time below range (TBR), coefficient of variation (CV), or prevalence of chronic microvascular and macrovascular complications. Conclusions Persistent C-peptide secretion in patients with T1DM was associated with significantly better metabolic control reflected by different glucose metrics, namely, TIR, TAR, GMI, and HbA1c. Cpeptide C peptide CGM (CGM T1DM. TDM . T DM (T1DM) Retrospective 11 therapy <0.05 005 0 05 (<0.0 ng/mL ngmL ng mL ≥0.05 (≥0.0 groups 2 1234 12 34 (12-34 185 18 5 18. 1229 29 (12-29 27.5 275 27 (27. 16.538.5 165385 16.5 38.5 16 38 [16.5-38.5 175 17 17. 9.828.8 98288 9.8 28.8 9 8 28 [9.8-28.8 respectively 0.002 0002 002 14 (1 924 24 [9-24 1432 32 [14-32 0.004. 0004 0.004 004 0.004) sex, sex (sex index infusion, infusion , infusion) TAR (TAR 11.03, 1103 03 -11.03 0.002, GMI (GMI 0.55, 055 55 -0.55 0.024, 0024 0.024 024 0.024) 14.48, 1448 48 -14.48 0.045 0045 045 HbAc HbA c 0.41, 041 41 -0.41 0.035 0035 035 TIR (TIR β 713 7 13 7.13 0.044 0044 044 1142 42 11.42 0.001 0001 001 adjustments TBR, TBR (TBR) CV, CV (CV) namely (T1DM <0.0 00 (<0. ≥0.0 (≥0. 123 3 (12-3 122 (12-2 27. (27 538 16.538. 16538 165 16. 385 38. [16.5-38. 828 9.828. 9828 98 9. 288 28. [9.8-28. 0.00 000 ( 92 [9-2 143 [14-3 11.03 110 -11.0 0.55 -0.5 0.02 02 14.48 144 4 -14.4 0.04 04 0.41 -0.4 0.03 003 71 7.1 114 11.4 (TBR (CV <0. (<0 ≥0. (≥0 (12- (2 53 16.538 1653 [16.5-38 82 9.828 982 [9.8-28 0.0 [9- [14- 11.0 -11. 0.5 -0. 14.4 -14. 0.4 7. 11. <0 (< ≥0 (≥ (12 16.53 [16.5-3 9.82 [9.8-2 0. [9 [14 -11 -0 14. -14 < ≥ [16.5- [9.8- [ [1 -1 - [16.5 [9.8 [16. [9. [16

SUMMARY Hyperreninemic hypoaldosteronism due to aldosterone synthase (AS) deficiency is a rare condition typically presenting as salt-wasting syndrome in the neonatal period. A one-month-old Portuguese boy born to non-consanguineous parents was examined for feeding difficulties and poor weight gain. A laboratory workup revealed severe hyponatremia, hyperkaliaemia and high plasma renin with unappropriated normal plasma aldosterone levels, raising the suspicion of AS deficiency. Genetic analysis showed double homozygous of two different mutations in the CYP11B2 gene: p.Glu198Asp in exon 3 and p.Val386Ala in exon 7. The patient maintains regular follow-up visits in endocrinology clinics and has demonstrated a favourable clinical and laboratory response to mineralocorticoid therapy. To our knowledge, this is the first Portuguese case of AS deficiency reported with confirmed genetic analysis.