Clinical Characteristics, Residual Beta-Cell Function and Pancreatic Auto-Antibodies in Thai people with Long-Standing Type 1 Diabetes Mellitus

  • Yotsapon Thewjitcharoen Theptarin Hospital, Bangkok https://orcid.org/0000-0002-2317-4041
  • Sirinate Krittiyawong Theptarin Hospital, Bangkok
  • Somboon Vongterapak Theptarin Hospital, Bangkok
  • Soontaree Nakasatien Diabetes and Thyroid center, Theptarin Hospital, Bangkok
  • Suphab Aroonparkmongkol Faculty of Medicine, Chulalongkorn University, Bangkok
  • Ishant Khurana Faculty of Medicine Nursing and Health Sciences, Monash University
  • Assam El-Osta Faculty of Medicine Nursing and Health Sciences, Monash University
  • Thep Himathongkam Theptarin Hospital, Bangkok
Keywords: type 1 diabetes mellitus, long-standing, residual beta-cell function, pancreatic autoantibodies, Thai people

Abstract

Objectives. To describe the characteristics of long-standing T1DM in Thai patients and assess residual beta-cell
function with status of pancreatic autoantibodies.

Methodology. This is a cross-sectional study of Thai subjects with T1DM and disease duration ≥25 years seen at
the Theptarin Hospital. Random plasma C-peptide and pancreatic auto-antibodies (Anti-GAD, Anti-IA2, and Anti-ZnT8) were measured. Patients who developed complications were compared with those who remained free of complications.

Results. A total of 20 patients (males 65%, mean age 49.4±12.0 years, BMI 22.5±3.1 kg/m2, A1C 7.9±1.6%) with
diabetes duration of 31.9±5.1 years were studied. Half of the participants remained free from any diabetic complications while the proportions reporting retinopathy, nephropathy, and neuropathy were 40%, 30%, and 15%, respectively. HDL cholesterol was significantly higher and triglyceride concentration significantly lower in patients who were free from diabetic nephropathy but not in those who were free from other complications. The prevalence rates of anti-GAD, anti-IA2, and anti-ZnT8 were 65%, 20%, and 10%, respectively. None of the patients who tested negative for both anti-GAD and anti-IA2 was positive for anti-ZnT8. Residual beta-cell function based on detectable random plasma C-peptide (≥0.1 ng/mL) and MMTT was found in only 3 patients (15%). There was no relationship between residual beta-cell function and protective effects of diabetic complications.

Conclusion. Endogenous insulin secretion persists in some patients with long-standing T1DM and half of longstanding T1DM in Thai patients showed no diabetic complications. HDL cholesterol was significantly higher and triglyceride concentration significantly lower in patients who were free from diabetic nephropathy.

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Author Biographies

Yotsapon Thewjitcharoen, Theptarin Hospital, Bangkok

Diabetes and Thyroid Center

Sirinate Krittiyawong, Theptarin Hospital, Bangkok

Diabetes and Thyroid Center

Somboon Vongterapak, Theptarin Hospital, Bangkok

Diabetes and Thyroid Center

Suphab Aroonparkmongkol , Faculty of Medicine, Chulalongkorn University, Bangkok

Division of Pediatric Endocrinology

Department of Pediatrics

Ishant Khurana, Faculty of Medicine Nursing and Health Sciences, Monash University

Epigenetics in Human Health and Disease Laboratory

Department of Diabetes

Central Clinical School

 

Assam El-Osta, Faculty of Medicine Nursing and Health Sciences, Monash University

Epigenetics in Human Health and Disease Laboratory

Department of Diabetes

Central Clinical School

Thep Himathongkam, Theptarin Hospital, Bangkok

Diabetes and Thyroid Center

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Published
2020-08-03
How to Cite
Thewjitcharoen, Y., Krittiyawong, S., Vongterapak, S., Nakasatien , S., Aroonparkmongkol , S., Khurana, I., El-Osta, A., & Himathongkam, T. (2020). Clinical Characteristics, Residual Beta-Cell Function and Pancreatic Auto-Antibodies in Thai people with Long-Standing Type 1 Diabetes Mellitus. Journal of the ASEAN Federation of Endocrine Societies, 35(2). Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/845
Section
Original Articles