Abstract 59: Study of complications and metabolic syndrome in adults with type 1 DM

Background: Type 1 Diabetes mellitus (T1DM) is an autoimmune disease characterized by insulin deficiency and hyperglycemia. India has the highest number of prevalent T1DM of 2,29,400 and incident T1DM of 21,000 cases annuallybelow 20 years of age. This increased incidence in children and adolescents along with enhanced insulin access and better survival rates lead to higher prevalence in adults. There is a recent shift from a T1DM to a type 2 diabetes mellitus (T2DM) clinical profile with obesity and insulin resistance, termed double diabetes. This increases the risk of Metabolic Syndrome (MetS) in T1DM, more commonly in patients with family history of T2DM. It is associated with greater body mass index, greater insulin requirements and worse metabolic control. There is limited data on MetS in T1DM from developing countries and its association with vascular complications. This study looked into the clinical profile of complications and MetS in adults with T1DM at a tertiary centre in North Andhra Pradesh Methods: This cross-sectional study included consecutive patients aged over 18 years and diagnosed as T1DM based on absence of beta cell reserve and requirement of insulin from diagnosis with at least 3 years duration, attending the Department of Endocrinology, King George Hospital, Visakhapatnam between July 2021 to June 2022. Data on clinical and biochemical characteristics as well as complications was collected. MetS was determined by modified NCEP-ATP III criteria Results: The study included 53 adults with T1DM with a mean age of 25.6 ± 6.0 years and mean diabetes duration of 12.7 ± 5.7y. The mean BMI was 21.2 ± 3.8 kg/m2 and mean HbA1c was 9.7 ± 2.5%. 83% of patients had DKA and 54% had recurrent hypoglycemia. Microvascular complications like Neuropathy, Nephropathy and Retinopathy were observed in 51.2%, 29.2% and 19.5% of patients respectively. 2 patients developed Peripheral Arterial Disease, 1 had Stroke and none had coronary artery disease. Patients with longer duration of DM (>10 years) had higher rate of microvascular complications. Overall, 21% of adults with T1DM had MetS. Patients with MetS were older, had longer diabetes duration and higher BMI. Diabetic Neuropathy (82% vs 33%), Retinopathy (45% vs 7%) and Microalbuminuria (45% vs 12%) were higher in patients with MetS when compared to those without MetS Conclusion: MetS is present in about a quarter of our T1DM patients, and had higher occurrence of retinopathy, neuropathy and nephropathy. As MetS is likely to increase the risk of atherosclerotic cardiovascular disease, the timely detection of MetS in T1DM has important preventive and therapeutic implications for cardiovascular disease.