ESPE Abstracts

Background: Carnitine deficiency (CD) has been reported in children at time of type 1 diabetes (T1D) diagnosis. By impairing free fatty acid ß-oxidation in liver, muscle mass and pancreatic ß cells, CD might impair glucose homeostasis and residual insulin secretion. We postulate that reversed of these FAO defects may help regenerate a healthier ß cell mass and increased the diabetes honeymoon duration.

Objective: Evaluate the effects of carnitine supplementation during the first months following the diagnosis of childhood T1D.

Patients: 24 children chosen at random at diagnosis of T1D (age 3–16 years, with positives antibodies) were assigned to carnitine supplementation (“carn+”) with 100 mg/k carnitine per day. They were compared to 25 non-treated children (“carn-”). Severe ketoacidocetosis at diagnosis excluded. Non-compliance was excluded by an elevation of plasma carnitine in “carn+” group compared to “carn−” group during the follow up.

Results: Children of the “carn+” and “carn−” groups were comparable at diagnosis for duration of nycthuria, weight loss, HbA1c, C peptide, pH, sexe, age. At diagnosis, the mean plasma carnitine level for all patients was 32.7 μmol/l (min:18–max:47) (normal values: 43–65 μmol/l). At 3–4 months, HbA1c was 6.7% in “carn+” and 6.5% in “carn−”, with insulin doses 0.7U.K.d and 0.6U.k.d respectively. C peptide was 0.1–1.8 in “carn+” and 0.3–3.5 μg/l in “carn−” (NS). Gained weight was 11% of initial body weight in the two groups.

Conclusion: CD at T1D diagnosis is confirmed. No change was observed between the two groups during the first 3 months after the diagnosis of T1D. A longer follow up is necessary to see if carnitine suplementation could increase remission duration and magnitude in T1D.