Endocrine Abstracts

Introduction: Metabolic syndrome (MS) is responsible for the increased cardiovascular risk in type 2 diabetics, but few studies have looked at the metabolic syndrome in type 1 diabetics. The aim of This study is to evaluate the prevalence of microvascular and macrovascular complications and evaluate the cardiovascular risk among patients with T1DM associated with metabolic syndrome.

Materials and Methods: Retrospective study which included 36 type 1 diabetics, hospitalized in the diabetology endocrinology department CHU Hedi Chaker in Sfax, with a metabolic syndrome from 1997 to 2018, MetS was defined according to the NCEP-ATP III criteria.

Results: The average age of our patients was 53 years (extremes: 26-80). a female predominant is noted (21 men vs 15 women) with a sex ratio of H/F to 1,4. Diabetes duration average was 15 years. Metabolic syndrome occurred after an average duration of diabetes of 13.7 years (E: 1-35). HTA was present in 21 patients (58.3%). The mean BMI was 26 kg/m², 19.7% of patients were obese. The average waist circumference was 95.5 cm. an android distribution of fat was present in 3 women. The mean total cholesterol level was 7 mmol/l, that of triglycerides was 3.3 mmol/l. hypertriglyceridaemia was present in 17 cases. The average HDL cholesterol level was 0.6 g/l. hypoHDLemia was present in 20 cases. The DM consisted of 3 criteria in 22 cases, 4 criteria in 11 cases and 5 criteria in 3 cases. In the majority of cases, it was the combination of dyslipidemia, HTA plus diabetes (80%). Therapeutically, the average dose of insulin used was 0.8 IU/kg/day (0.2-1.4). The combination of an insulin sensitizer was required in 3 cases. Hepatic steatosis was present in 8 cases. Microvascular complications were present in all patients with retinopathy (74%) and nephropathy (86%). Macrovascular complications, such as coronary insufficiency, were present in 20% of cases. The Cardiovascular risk is very high in all patients.

Conclusion: The prevalence of metabolic syndrome during type 1 diabetes is increasing. Its presence indicates an increased risk for micro- and macrovascular complications. A comprehensive management including lifestyle modification might reduce their risk of micro and macrovascular complications in adults with T1DM and MetS.