1. Study of the difficult glycemic control in relation to the presence of diabetes-autoantibodies in a sample of Egyptians with type 1 diabetes.
- Author
-
Hamed MS, Samy M, Mahmoud H, and Yehia N
- Subjects
- Adolescent, Adult, Autoantibodies immunology, C-Peptide blood, Cohort Studies, Cross-Sectional Studies, Diabetes Mellitus, Type 1 epidemiology, Diabetes Mellitus, Type 1 immunology, Egypt epidemiology, Female, Glutamate Decarboxylase immunology, Humans, Insulin immunology, Insulin Antibodies blood, Male, Receptor-Like Protein Tyrosine Phosphatases, Class 8 immunology, Young Adult, Autoantibodies blood, Blood Glucose metabolism, Diabetes Mellitus, Type 1 blood
- Abstract
Background: T1DM is divided into 1A (immune-mediated), 1B (virus-triggered, genetic and idiopathic). Presence of auto-antibodies may be correlated to glycemic control., Aim: Assessment relation between the autoantibodies and the poor glycemic control in T1DM., Methods: 60 patients T1DM 30 males, 30 females, subjected to full history, clinical, anthropometric assessment and laboratory assessment of fasting C-peptide, FBS, 2 h PP glucose, HbA1c, GADA, ICA and IAA level. Classified into two groups; Group I: negative auto-antibodies, Group II: positive auto-antibodies, Group II was further classified into 3 sub-groups, Group II a:1 positive autoantibody, Group II b: 2 positive autoantibodies and Group II c: 3 positive autoantibodies., Results: HbA1c was significantly higher in group II than group I (11.85 ± 1.61% vs. 8.52 ± 0.41%, p = 0.000). HbA1c was highest in group IIc followed by IIb then IIa (12.25 ± 1.48% vs. 11.57 ± 1.59% vs. 10.78 ± 1.73%, p = 0.038). Total insulin units per day was significantly higher in group II than group I (109.83 ± 7.77 U/day vs. 100.83 ± 1.83 U/day, p = 0.007). Duration of diabetes was significantly higher in group I than group II (10.17 ± 1.94 years vs. 8.11 ± 2.20 years, p = 0.033). HbA1c, total insulin units per day and duration of diabetes were independent predictive factors for presence of autoantibodies (p = 0.007, p = 0.033 and p = 0.043 respectively)., Conclusion: Autoantibodies affect the glycemic control presented by high HbA1c; also it causes increase in total insulin units needed by patients; the more autoantibodies, the higher HbA1c, the more insulin units required to control glycemic state., (Copyright © 2019. Published by Elsevier B.V.)
- Published
- 2019
- Full Text
- View/download PDF