Endocrine Abstracts

Introduction

Diabetes mellitus is a serious metabolic disease, described by the World Health Organization as a global epidemic. An alarming increase in its prevalence among adults is observed in Tunisia as everywhere else in the world. Because type 2 diabetes preponderates among adults, few epidemiological studies focused on type 1 diabetes (T1D) that occurs during the adulthood. The aim of this study is to determine the prevalence of DT1 among Tunisian adults and identify their clinical and biological features.

Patients and methods

This study was carried out on adults who had diabetes diagnosed after the age of 20 years (n = 280), in Sfax (the south west of Tunisia) during the period from January 2011 to December 2019. Various clinical and biochemical parameters were evaluated.

Results

Among the 280 included adults, 166 (59%) were diagnosed with type 1 diabetes. An average of 9 patients per year was newly diagnosed with T1D after the age of 20 years. In our study, 22.9% of patients were ethylic and 44% were smokers. The mean age at onset was 31.81 years old ± 9.39 (range, 20–64 years) with significant male predominance (P = 0.01) and a sex ratio of 1.34. Approximately 71% of patients had a family history of diabetes. High blood pressure (56%), obesity (26.5%) and ischemic heart disease (12.7%) were the most common family histories. Only 46 patients (27.7%) had an autoimmune disease besides diabetes. The association of another autoimmune disease with diabetes was significantly more common in women (P < 0.05).Furthermore, adults presenting with another autoimmune disease were significantly older than those without (P < 0.05). The mean of basal metabolic index (BMI) was 21.05 kg/m². Underweight was found in 23.5% of cases and 63.9% of patients had normal BMI. Overweight and obesity were observed in 9% and 3.6% of patients, respectively. Ketosis were observed in 50.6% of cases, with beta cell decline ranging from 1 week to 24 months, preceded by oral therapy in 24.1% of cases. Mean blood glucose was 21.01 ± 7 mmol/l and mean glycated hemoglobin (HbA1c) was 11.88 ± 2.51% Glutamic acid decarboxylase (GAD) autoantibodies were positive in 97.6% of cases with a mean average of 485.31 ± 431.5 UI. Protein tyrosine phosphate (IA2) and islet cell (ICA) autoantibodies were positive in 13.3 and 17.4% of cases, respectively.

Conclusion

This study provided an estimate of incidence of diagnosed T1D among Tunisian adults and highlights the importance of its screening even during adulthood.