Endocrine Abstracts

Introduction : Type 1 diabetes (T1DM) is an autoimmune disease that commonly affects a young population. Its evolution can be characterized by a frequent occurrence of degenerative complications. Our aims were to study microangiopathic complications, lipid profile, and the presence of other autoimmune diseases in type 1 diabetic patients whose diabetes has been evolving for 10 years or more.

Method : This is a descriptive cross-sectional study including T1DM patients (with diabetes of 10 years or more), conducted in department A of the National Institute of Nutrition in Tunis during the year 2022.

Results : Our study included 67 T1DM patients, predominantly female (61.2%). The average age of our patients varied from 16 to 67 years with a mean of 35±12 years. The mean duration of diabetes progression was 17.7±7 years. Among our patients 20.9% had hypothyroidism and 9% had hyperthyroidism. Celiac disease was present in 6% of patients. Only one patient had adrenal insufficiency. Microangiopathic complications were dominated by diabetic retinopathy (50.2%), then diabetic nephropathy (31.3%) and diabetic neuropathy (22.4%). More than 2 thirds of patients (86.6%) had poorly controlled diabetes (HB1AC>7%) with a mean HB1AC of 10±2%. Hypertriglyceridemia was present in 19.4% with a mean triglyceride level of 1.29 mmol/l. The mean LDL cholesterol level was 1.05±0.23g/l. low HDL cholesterol levels were noted in 31.3% with a mean HDL cholesterol level of 1.24± 0.31 mmol/l. A positive association was noted between low HDL cholesterol and diabetic retinopathy (P=0.025). The decrease in HDL cholesterol was also positively associated with diabetic neuropathy (P=0.45) and diabetic nephropathy (P=0.05).

Conclusion : Degenerative complications are common after 10 years of T1DM progression, hence the need for early management to prevent or delay the onset of chronic complications of T1DM. A low HDL cholesterol level could be a risk factor for the development of these complications.