Endocrine Abstracts

Type 1 diabetes mellitus (DM) is a multi system disease with both biochemical and anatomic/structural consequences. A number of components of the metabolic syndrome may be observed in patients with type 1 diabetes. It was suggested that treating obese adolescents with insulin resistance using metformin is an option for patients without response to traditional lifestyle change. It was reported that fetuin-A could inhibit insulin receptor tyrosine kinase activity and induced a lower-grade inflammation which resulted in IR.

Objective: To Measure serum fetuin-A level in type 1 DM male patients with and without IR and to study the Effect of metformin therapy on fetuin-A level and parameters of metabolic syndrome in type 1 DM male patients.

Study design: The study was conducted on two phases: first phase: a comparative study between three groups: Group 1:20 male patients with type 1 DM without IR. Group 2:20 male patients with type 1 DM with IR and Group 3:20 age and sex matched apparently healthy controls. second phase: interventional study, includes measurement of serum fetuin-A and other parameters of metabolic syndrome on patients included in group 2 after metformin therapy for 3 months.

Results: Group 2 had a significant higher BMI, waist:hip ratio (W:H ratio), fasting blood glucose (FBG), 2 h post prandial blood glucose (2 h PP BG), HBA1C%, Triglycerides (TG) LDL cholesterol, hs-CRP, and serum fetuin-A ratio and a significant lower eGDR and C-peptide (P<0.001). Serum fetuin-A had a direct significant correlation with BMI, waist circumference, W:H ratio FBG, 2 h PP BG,HBA1C%, LDL, cholesterol, TG, and hs-CRP and an indirect significant correlation with C-Peptide and e GDR. Patients in group 2 had significant improvement in eGDR, 2 h PP BG, HbA1C%, hs-CRP, and serum fetuin-A after metformin. EGDR was significantly correlated with HBA1C% and W:H ratio (P<0.001).

Conclusion: Patients with type 1 DM may have IR in association with insulin deficiency, those patients have higher fetuin-A levels, use of metformin may play a role in improvement of insulin sensitivity and decreasing insulin requirements in type 1 DM.