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Volume 4 No. 2, April 2009 |
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Association between Type1diabetes Mellitus and Metabolic Syndrome Alsayed M. Alsalamony(1) & Abdulhalim A. Abdulhalim(2)
Internal Medicine Department, Mansoura University (1);
Medical Biochemistry(2), Assiut University, Egypt
Background/Aim: Although metabolic syndrome is a characteristic
usually associated with the development of type 2 diabetes, it can
also be a feature of patients with type1diabetes. When present in
type1diabetes, the phrase “double diabetes” has been coined, with
the assumption that these patients are likely to be at especially
high risk of developing cardiovascular disease. The Aim of this
study is to quantify metabolic syndrome according to new
international diabetic federation (IDF) definition in type 1
diabetes patients and to clarify its relationship with chronic
complications by estimated glucose disposal rate (eGDR), and insulin
resistance score. Patients & Methods: Cross-sectional study in 40
patients with type 1 diabetes managed at Diabetes and Endocrinology
Center (all participants aged 18 years or older with type1 diabetes
duration of more than 1 year). New International Diabetes Federation
(IDF) criteria were used to identify the metabolic syndrome at
baseline. Insulin resistance score was calculated using estimated
glucose disposal rate (eGDR). Insulin dose (units/kg) was also used
as a separate marker of insulin resistance. Results: There were 22
females and 18 males with a mean age of 24.3 ± 2.7 (18-34) years
.Eight patients met metabolic syndrome criteria, yielding a
prevalence of 20%. The IRS score had a significant inverse
correlation with the eGDR (r = –0.94, P< 0.001).There is a
significant positive correlation between insulin resistance score
and metabolic syndrome parameters, including BMI (r=0.5, p=0.001),
WHR (r=0.4, p=0.01),systolic and diastolic blood pressure (r=0.5,
p=0.001, r=0.3, p=0.03 respectively), serum triglycerides level
(r=0.58,p=0.000), and hemoglobin A1c (r=0.42,p=0.007), duration of
diabetes (r=0.53,p=0.001) and insulin dosage (r=0.8,p=0.000),while
there is a significant negative correlation between insulin
resistance score and serum level of high density lipoprotein
cholesterol (HDL) (r=-0.49, P=0.001). By comparison of diabetic
patients with and without metabolic syndrome we found a
statistically significant difference in different parameters of
metabolic syndrome, estimated glucose disposal rate p=0.001, and
insulin requirements between diabetic patients with and without
metabolic syndrome p=0.02. Conclusion & recommendation: The study
concludes that metabolic syndrome is a frequent finding in type 1
diabetes, along with microvascular complications, 37.5% have
retinopathy, 25% have nephropathy. Higher insulin resistance score
at baseline was associated with increased subsequent risk of both
micro- and macrovascular complications. So it's advisable to prevent
the occurrence of metabolic syndrome in patients with type 1
diabetes to avoid both micro- and macrovascular complications of
diabetes mellitus. |
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