Endocrine Abstracts

Introduction: Metabolic syndrome (MS) is responsible for the increased cardiovascular risk in type 2 diabetics. There is a scarcity of research on the metabolic syndrome among individuals diagnosed with type 1 diabetes (T1DM). The aim of this study is to describe clinical, biochemical and therapeutic characteristics of T1DM with MS.

Materials and Methods: Retrospective study including 36 patients, with T1DM and MS, hospitalized in the department of Endocrinology in Hedi-Chaker Universital Hospital in Sfax/Tunisia, from 1997 to 2020. MS was defined according to the NCEP-ATP III criteria.

Results: The average age of our patients was 53 years (extremes: 26-80). A male predominance was noted with a sex ratio of H/F to 1,4. The average duration of diabetes was 15 years. Metabolic syndrome occurred after an average duration of diabetes of 13.7 years. Hypertension was noted in 21 patients (58.3%). The mean BMI was 26 kg/m², 19.7% of patients were obese. The average waist circumference was 95.5 cm±10.7. An android distribution of fat was present in 14 women. The mean total cholesterol level was 4.59 mmol/l ± 1.18 and mean triglycerides level was 1.67 mmol/l ± 0.81. Hypertriglyceridemia was present in 17 cases. The average HDL cholesterol level was 0,96 mmol/l ±0.29. Low HDL-cholesterol level was present in 20 cases. The MS comprised of 3 criteria in 22 cases, 4 criteria in 11cases and 5 criteria in 3 cases. In the majority of cases, it was the combination of dyslipidemia, hypertension and diabetes (80%). Therapeutically, the average dose of insulin used was 0.8 IU/kg/day. The association of metformin was required in 18 cases (50%). Microvascular complications were present in all patients consisting of retinopathy (55.6%) and nephropathy (41.7%) and neuropathy (63.9%). Macrovascular complications, such as coronary insufficiency, were present in 20% of cases. The Cardiovascular risk was very high in all patients.

Conclusions: The prevalence of metabolic syndrome during type 1 diabetes is increasing. It indicates an increased risk for micro-and macrovascular complications.