Endocrine Abstracts

Introduction: Contrary to type 2 diabetes, type 1 often occurs in young people, without obesity or cardiovascular or metabolic diseases. The association of type 1 diabetes with an authentic metabolic syndrome including obesity is very rare, though possible, with a mixed clinical picture. The goal of our study is to evaluate the association of type 1 diabetes with the metabolic syndrome.

Material and methods: This is a retrospective cross-sectional study based on the observation of patients admitted for diabetes with insulin deficiency. The positivity of anti-pancreas antibodies testified to the auto-immune characteristic; anti glutamic acid decarboxylase GAD and/or anti tyrosine phosphatase IA2. The goal of the study is to determine the patients’ clinical and biological aspects as well as their metabolic profile.

Results: Our series was conducted with 359 patients: 209 men and 150 women, aged between 10 and 69 years with an average of 28.75 years. Metabolic heredity was found in 26 patients (7.2%), Diabetes heredity in 216 patients (60.1%); 147 (40.9%) of whom with type 2 history and 69 (19.2%) with type 1 history. Vascular heredity was found in 27 patients (7.5%). 117 patients (32.6%) were smokers and alcohol consumption was found in 85 of them (23.7%). The clinical picture was ketotic in the majority of cases: 336 (93.6%), with inaugural ketosis in 313 cases (87.2%). Insulin deficiency varied between one week an 36 months, with an average of 3.75 months and a standard deviation of 6.8 months, exceeding 6 months achieving a slow form and a previous oral treatment in 24% of cases. Regarding weight, the average BMI was 22 (extremes: 15 and 39), over 30 in 22 patients. Overweight was more significant in patients over 20 years old, with 6% in the younger population, 14% between the ages of 20 and 40, and 34% in the patients over 40 years of age. Regarding waist size in women, a size over 80 cm was more significant in patients over 40 (38%) against 4% in women younger than 20. Men’s waist size over 94 cm was more significant in patients over 40 (19%), against 4% in the ones younger than 20. An obesity previous to the discovery of Diabetes was found in 80 patients (22%). Hypertension was found in 14 patients (4%). Upon admission, average blood sugar levels were 16.40 mmol/l with an average glycosylated hemoglobin HbA1C of 12.32%. Average LDL levels were of 0.912 g/l with a minimum of 0.2 g/l and a maximum of 3.18 g/l.

Conclusion: Even though obesity is often associated with type 2 Diabetes, some type 1 Diabetics present with a metabolic syndrome that could mislead the diagnosis and delay the appropriate management. Obesity in type 1 Diabetes is more correlated with advanced age and metabolic heredity.