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Pol Arch Intern Med. 2019 Aug 5. doi: 10.20452/pamw.14920. [Epub ahead of print]

Changes in high-density lipoprotein cholesterol (HDL-C) level and triglyceride/HDL-C ratio during the first year of type 1 diabetes mellitus: Prospective observational study InLipoDiab1.

Abstract

INTRODUCTION:

Patients in an insulin deficient state show reduced high-density lipoprotein cholesterol (HDL-C) level. Insulin treatment influences lipid metabolism in this group of patients. There are no prospective studies evaluating changes in lipid profile since the diagnosis of type 1 diabetes mellitus (T1DM).

OBJECTIVES:

To investigate the influence of subcutaneous insulin therapy initiation on quantitative changes of HDL-C level and other components of lipid profile, in patients with newly diagnosed T1DM.

PATIENTS AND METHODS:

127 patients with newly diagnosed T1DM aged 28 (IQR, 23-34) years were enrolled to the prospective observation within the Insulin Therapy and Lipoproteins Profile in Type 1 Diabetes Study. The lipid profile was assessed before the first injection of insulin (baseline), after 3 and 12 months of insulin therapy. The daily dose of insulin (DDI) was defined as the requirement for insulin per kilogram body weight per day. DDI was calculated at discharge from the hospital and during visits in the outpatient clinic after 3 and 12 months.

RESULTS:

The persistent increase in HDL-C level at 3 and 12 months versus baseline (p<0.001) was observed in men and women. Moreover, significant reductions were observed in triglycerides level (p<0.001) and triglyceride/HDL-C ratio (p<0.001) in men and women. In low-density lipoprotein cholesterol and non-HDL-C, a significant decrease was observed (p<0.001), but only in men with T1DM.

CONCLUSIONS:

Subcutaneous insulin therapy reverses the impaired phenotype of lipoproteins during the first year of treatment. There is a difference in the lipoproteins level changes in newly diagnosed T1DM according to sex.

PMID:
31379357
DOI:
10.20452/pamw.14920
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