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 316 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:18max:47) (normal values: 4365 μmol/l). At 34 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 0.11.8 in carn+ and 0.33.5 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.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology