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Med Wieku Rozwoj. 2005 Apr-Jun;9(2):223-34.

[The role of insulin secretion and insulin resistance in the clinical course of newly diagnosed diabetes mellitus in children].

[Article in Polish]

Author information

  • 1Klinika Chorób Dzieci, Katedra Pediatrii, Uniwersytet Medyczny, ul. Sporna 36/50, 91-738 Łódź, Poland.

Abstract

BACKGROUND:

The prevailing type of diabetes in Caucasian children and adolescents is type l. Insulin resistance resulting from decreased physical activity and obesity may account for the rising incidence of type l and type 2 diabetes mellitus in this group.

AIM:

To estimate the role of insulin secretion and insulin resistance in the clinical course of new onset type l diabetes mellitus in children and adolescents.

MATERIALS AND METHODS:

58 patients aged 7.6-17.9 years, underwent investigations within the first 7 days after diabetes mellitus diagnosis. In 56 individuals type l and in 2 - type 2, was diagnosed. Insulin secretion was estimated by measurement of the serum C-peptide concentration in glucagon test while the Euglycemic-hyperinsulinemic clamp was performed to assess insulin resistance. HbA1c, glycemia and pH were examined. Body mass index (BMI) and the required daily dose of insulin (DDI) were calculated.

RESULTS:

In patients with diabetes C-peptide level was 0.03-1.5 pmol/ml. Index M ranged from 1.5 to 13.09 mg/kg/min. The hyperbolic relation was observed between C-peptide level and index M (r=0.62). There was a positive correlation between age at diabetes onset and C-peptide level (r=0.25) and negative with index M (r=-0.59). C-peptide level and index M correlated with body mass index (r=0.58; r=0.59; respectively). A relationship between glycemia and C-peptide level (r=-0.42) and index M (r=0.26) was found. Correlation between HbA1c and C-peptide level (r=-0,42; p=0.001) and index M (r=0.3) was observed. Dose of insulin correlated with C-peptide level (r=-0,2).

CONCLUSIONS:

In children with newly diagnosed diabetes mellitus a great variability of insulin secretion and insulin resistance was observed and a hyberbolic function between them. There was a relationship between insulin secretion and insulin resistance with age at onset and obesity. C-peptide level mainly determined HbA1c, glycaemia, pH and the needed dose of insulin.

PMID:
16085963
[PubMed - indexed for MEDLINE]
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