Background: young children with type 1 diabetes mellitus (DM1) have a tendency to recurrent hypoglycemia. Increased sensitivity to insulin in young diabetes patients may be associated with features of secretion of catecholamine, particularly adrenaline.
The aim: to explore the basal levels of catecholamine (epinephrine, norepinephrine, and dopamine) in serum of young children with type 1 diabetes mellitus to identify of possible relationships between autonomic neuropathy, declining levels of catecholamine and hyperinsulinism.
Methods: Basal levels of dopamine (DA), epinephrine (E), and norepinephrine (NE) in plasma were measured by the method of high performance liquid chromatography with electrochemical detection (equipment "Beckman's System Gold") in 31 children with type 1 diabetes (average age of 4.7 ± 0.26 years yrs; average duration of diabetes 2.1 + 0.2 years). Body mass index (BMI) of children was averaged 15.4 ± 0.8 kg/m2. The degree of metabolic control was assessed by the levels of HbA1c, which were from 7.5% to 10.5% (average of 8.7 ± 1.6%). Nobody of diabetes patients had clinical evidence of diabetic peripheral or autonomic neuropathy. All children receive insulin injections in average dose of 0.7 ± 0.1 U/kg/day. The control group consisted of 8 healthy children (mean age 5.1 ± 0.2 years, average BMI 15.9 ± 0.5 kg/m2).
Results: norepinephrine, dopamine and total catecholamine were decreasing in young children with DM1 compared to the control group. Epinephrine in DM1 patients did not differ from the control. We compared of catecholamine in patients with good metabolic control (HbA1c ≤ 7.5 %, n = 16) and the poor metabolic control (HbA1c > 8.0%; n = 15) and found that in children with a good control dopamine, norepinephrine, epinephrine and total catecholamine were below in comparison with healthy children. We analyzed the influence of the duration of the DM1 on levels of plasma catecholamine. Children with DM1 duration more than 2 years (2.9 ± 0.2 years, n = 14) had basal levels E, NE, DA and total catecholamine significantly lower compared with health control and patients with less diabetes duration (1.19 ± 0.22 years, n = 17), but statistical reliability when comparing these groups of patients had not been received. Not established correlation between the doses of insulin and serum catecholamine levels.
Conclusions: This study revealed the significant suppressing of total catecholamine, epinephrine, norepinephrine, and dopamine in young children with good metabolic control of type 1 diabetes mellitus.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology