Aims: Anxiety, depression, and disease-related distress are linked to worse overall glycaemic control, in terms of HbA1c. This study was aimed to evaluate whether these emotional disorders are associated with long-term glycaemic variability in subjects with Type 1 diabetes. Methods: Longitudinal retrospective study. Six-year HbA1c data (2014-2019) from 411 subjects with Type 1 diabetes who had participated in a previous study to design a diabetes-specific quality of life questionnaire in the year 2014 were included. Scores for Spanish versions of the Hospital Anxiety and Depression Scale (HADS) and Problem Areas in Diabetes (PAID) scale were obtained at baseline, along with sociodemographic and clinical data. Long-term glycaemic variability was measured as the coefficient of variation of HbA1c (HbA1c-CV). The association between HADS and PAID scores and HbA1c-CV was analysed with Spearman correlations and multiple regression models, both linear and additive, including other covariates (age, sex, diabetes duration time, type of treatment, use of anxiolytic or antidepressant drugs, education level and employment status). Results: Scores of depression, anxiety and distress were positively and significantly correlated to HbA1c-CV in univariate analyses. Multiple regression study demonstrated an independent association only for diabetes distress and anxiety scores (p= 0.010 and p=0.015, respectively). Age, diabetes duration time, education level and employment status were also significantly associated with HbA1c-CV. Conclusion: There is a relationship between psychological factors and long-term glycaemic variability in subjects with Type 1 diabetes.

Background: Denosumab is a monoclonal antibody approved for the treat-ment of postmenopausal osteoporosis. The withdrawal of denosumab produc-es an abrupt loss of bone mineral density and may cause multiple vertebral fractures (MVF). Objective: To study the clinical, biochemical and densitometric characteristics in a large series of postmenopausal women who suffered MVF after deno-sumab withdrawal. Likewise, we try to identify those factors related to the presence of a greater number of vertebral fractures (VF). Patients and Methods: 56 patients (54 women) who suffered MVF after re-ceiving denosumab at least for 3 consecutive years and abruptly suspended it. A clinical examination was carried out. Biochemical bone remodeling markers (BBRM) and bone densitometry at the lumbar spine and proximal femur were measured. VF were diagnosed by MRI, X-ray or both at dorsal and lumbar spine. Results: 56 patients presented a total of 192 VF. 41 patients (73.2%) had not previously suffered VF. After discontinuation of the drug, a statistically signifi-cant increase in the BBRM was observed. In the multivariate analysis, only the time that denosumab was previously received was associated with the pres-ence of a greater number of VF (p = 0.04). Conclusions: We present the series with the largest number of patients col-lected to date. 56 patients accumulated 192 new VF. After the suspension of denosumab and the production of MVF, an increase in the serum values of the BBRM. The time of denosumab use was the only parameter associated with a greater number of fractures.