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Diabetes Res Clin Pract. 2019 May 4. pii: S0168-8227(19)30065-8. doi: 10.1016/j.diabres.2019.04.026. [Epub ahead of print]

Study of the difficult glycemic control in relation to the presence of diabetes-autoantibodies in a sample of Egyptians with type 1 diabetes.

Author information

1
Internal Medicine & Endocrinology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
2
Endocrinology Department, Ain Shams University, Cairo, Egypt.

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 hours 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.

KEYWORDS:

Diabetes autoantibodies; HbA1c level; T1DM; Total insulin units and Diabetes duration

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