PERSONALITY CHANGES AND SOCIAL ADJUSTMENT DURING THE FIRST THREE YEARS OF DIABETES IN CHILDREN

ABSTRACT. Ahnsjö, S., Humble, K., Larsson, Y., Settergren-Carlsson, G. (?) and Sterky, G. (Departments of Paediatrics and Child and Youth Psychiatry, the Karolinska Institute, Stockholm, the Department of Paediatrics, University Hospital, Linköpin, and the Department of Psychology, University of Stockholm, Sweden). Personality changes and social adjustment during the first three years of diabetes in children. Acta Paediatr Scand, 70:321, 1981.–Two groups of 64 diabetic and 30 carefully selected and matched non-diabetic control children 4–17 years old were studied with regard to psychological and social adaptation. Four sets of psycho-social methods were used: (a) psychiatric assessment of the mental state, (b) evaluation of the social situation, (c) measurement of the intellectual capacity, and (d) a Rorschach test. A base-line study was done within 5 months after the onset of diabetes and a follow-up 3 years later with the same methods. The mental state was assessed with regard to 18 variables, and the Rorschach test utilized 12 variables. There were no significance differences as to mental state between diabetics and non-diabetics neither at base-line nor at follow-up. Within each group, however, the diabetics showed an increase with regard to symptoms of aggression while the non-diabetics showed a decrease in such symptoms. Diabetics with high or low glucosuria levels did not differ in this respect. When summarizing mental deviations from average in the two groups the diabetics showed more deviations both at base-line and at follow-up, and a tendency towards higher degrees of mental activity, emotional ability and social contact. In the Rorschach test the diabetics showed a higher level of anxiety concerning their own health than the non-diabetics, but there was a decrease in this variable over the 3-year period. However, in an attempt to summarize the degree of mental disturbance, as estimated in the Rorschach test, no significant differences were found between diabetics and non-diabetics. Nor were any significant differences found between the groups with regard to social problems or intellectual capacity. It is concluded that the few abnormal patterns of raction that were observed may well be explained by the traumatic experience of the onset of a serious chronic disorder such as diabetes, and that a relatively strict care given to diabetic children does not seem to disturb their own or their parents' coping ability or psycho-social adjustment. The strictness might even have a supportive effect.     

B-CELL RESPONSE TO EXERCISE IN DIABETIC AND NON-DIABETIC CHILDREN

Abstract. Heding, L. G. and Ludvigsson, J. (Novo Research Institute, DK-2880 Bagsvaerd, Denmark and the Department of Pediatrics, Linköping University, S-581 85 Linköping, Sweden). B-cell response to exercise in diabetic and non-diabetic children. Acta Pediatr Scand, Suppl. 283: 57, 1980.—20 non-diabetic and 11 insulin dependent diabetic (IDD) children underwent short time (20 min) bicycle ergometer exercise followed by a 10 min rest period. Glucose, IRI, C-peptide and proinsulin were determined prior to and at the end of the exercise, and again after 10 min rest. While no significant change in mean glucose was observed during exercise in the non-diabetics, significant decreases were observed in IRI, C-peptide and proinsulin. After 10 min rest glucose as well as the three B-cell secretory products increased significantly. The change in glucose was Significantly ( p <0.001) correlated to the change in IRI. In the resting period IRI rose more than C-peptide in some subjects. IRI even rose without simultaneous rise in C-peptide indicating a release of tissue bound IRI. The group of IDD children did not show any significant changes in glucose and total IRI, while the endogenous insulin, as measured by C-peptide, did show a fall during exercise. The same was found for proinsulin. The lack of increased endogenous secretion during the rest period was most likely due to suppression of B-cell due to hyperinsulinism and lack of increased glucose concentrations during the rest period.     

Impact of glycemic control on serum lipoprotein (a) in Arab children with type 1 diabetes

BACKGROUND: Lipoprotein (a) (Lp (a)) is an independent risk factor for coronary artery disease (CAD), a major cause of death in patients with type 1 diabetes mellitus. Both type 1 diabetes and CAD represent major problems in Kuwait. Data on the effect of metabolic control on Lp (a) in diabetic children are limited and this is particularly true for Arab children. The objectives of the present study were to analyze serum Lp (a) levels in patients with type 1 diabetes compared with non-diabetic children, taking into account the effect of glycemic control. METHODS: Circulating lipids, including Lp (a), were measured in serum samples from 60 prepubertal non-diabetic children and 58 prepubertal children with type 1 diabetes. Comparisons of Lp (a) concentrations were made between the non-diabetic and diabetic children with good to fair control (glycosylated hemoglobin (GHb) <11%) and a group of diabetic children with poor control (GHb > or = 11%). RESULTS: The mean serum Lp (a) level in all diabetic children was 187.62+160.43 mg/L, compared with 162.88+156.06 mg/L in the control group. The group of children with poor glycemic control had higher median Lp (a) levels (147.50 mg/L) than either the group of diabetic children with good to fair control (95 mg/L; P<0.028) or the group of non-diabetic children (125 mg/L; P<0.04). Moreover, 38.3% of poorly controlled diabetic children had elevated Lp (a) levels > or = 250 mg/L, compared with 12.5% of diabetic children with good to fair control and 16.7% of non-diabetic children (P<0.025 and P<0.039, respectively). No association was found between Lp (a), diabetes duration and insulin dose. CONCLUSIONS: In Arab children, highest Lp (a) levels are associated with poorest metabolic control. The prevalence of Lp (a) levels associated with cardiovascular risk is higher in poorly controlled diabetic children. Increased levels of Lp (a) may be another contributing factor to the high risk for CAD in diabetic patients.     

RESYNTHESIS OF MUSCLE GLYCOGEN STORES DURING RECOVERY FROM PROLONGED EXERCISE IN NON-DIABETIC AND DIABETIC SUBJECTS

Abstract. Hermansen, L. Laboratory for Muscle Physiology, Work Research Institute, Oslo, Norway). Resynthesis of muscle glycogen stores during recovery from prolonged exercise in non-diabetic and diabetic subjects. Acta Paediatr Scand Suppl 283: 33, 1980.—Six male juvenile diabetics were compared with six non-diabetic male subjects regarding the rate of muscle glycogen resynthesis during recovery after prolonged exercise. The glycogen synthesis were similar in the two groups, which indicates that diabetics can participate in strenous daily physical activity just as non-diabetics.,     

Effect of maternal diabetes on the fetal exocrine pancreas

To test the hypothesis that fetal pancreatic exocrine and endocrine function are stimulated in parallel in the diabetic pregnancy, 68 mothers with gestational and pregestational diabetes who underwent amniocenteses after 34 weeks' for the evaluation of fetal lung maturity were enrolled. Amniotic fluid specimens were analyzed for C-peptide and trypsin content. Amniotic fluid specimens were obtained from 92 non-diabetic women undergoing amniocenteses for lung maturity, preterm labor, or premature rupture of membranes. Groups were compared using the Wilcoxon rank-sum test, Kruskal Wallis rank sum test, and Spearman's rank correlation test. C-peptide amniotic fluid concentrations were significantly greater in diabetics (median 0.6 ng/ml) than non-diabetics (median 0.4 ng/ml, P= 0.0001), in pregestational (median 0.6 ng/ml) vs. gestational diabetics (median 0.4 ng/ml, P = 0.006), and greater in proportion to severity of disease according to diabetic class (A1 = 0.4 ng/ml, A2 = 0.55 ng/ml, B = 0.6 ng/ml, C = 0.7 ng/ml, D = 0.85 ng/ml, P = 0.04). No significant differences were detected in amniotic fluid trypsin between the diabetic and non-diabetic or the gestational and non-gestational diabetic groups. There was no correlation between C-peptide and trypsin within the diabetic groups. Stimulation of the exocrine and endocrine pancreas does not occur in parallel in the fetus of the diabetic mother. Although originating as a single organ, pancreatic exocrine and endocrine functions are distinct in both physiologic and pathologic conditions.     

The Role of Excercise in the Metabolic Control of Juvenile Diabetes

Exercise has a beneficial metabolic effect in diabetic children and adolescents only when they are in good metabolic control with optimal insulin administration. In insulin-deficient patients exercise may seriously aggravate the diabetic state. The physical working capacity of young diabetics is often lower than that of non-diabetic children. Their physical fitness can be improved by regular training programs. Exercise-induced hypoglycemia is due to suppression of hepatic glucose output in response to an abnormal insulinemia. It can as a rule be prevented by a liberal carbohydrate intake before and during the exercise period. On a long-term basis regular physical activity improves diabetic control in young diabetics, increases glucose tolerance and normalizes blood lipids. Regular physical activity increases diabetics' sense of well-being, gives self-confidence and makes feelings of being handicapped disappear. Exercise may contribute topreventing the development of long-term diabetic microangiopathy andneuropathy. However, when such complications once have become manifest, the value of exercise is less obvious. It may even be harmful and should therefore, in such situations, be undertaken with great caution and after careful medical evaluation.     

Assessment of magnesium status in newly diagnosed diabetic children: measurement of erythrocyte magnesium level and magnesium tolerance testing

The aim of this study was to investigate the relationship between serum, erythrocyte and urine magnesium levels and retained magnesium percentage in newly diagnosed diabetic children. In a cross-sectional study, 34 children with insulin dependent diabetes mellitus (IDDM) and 21 healthy age- and sex-matched control subjects were screened for their serum, erythrocyte, and urine magnesium levels. Magnesium tolerance test was performed on diabetic and control subjects. Serum and erythrocyte magnesium levels in diabetic children were significantly lower than in healthy controls (plasma magnesium, p<0.05; erythrocyte magnesium, p<0.001); however, serum magnesium level was in normal range in diabetics and controls. Erythrocyte magnesium levels in diabetic children showed an inverse correlation with percentage of retained magnesium load (r=-0.44, p<0.01). Urine magnesium excretion in diabetic children (7.12 +/- 2.18 mmol/g creatinine/24-hr) was significantly higher than in healthy controls (4.0 +/- 1.35 mmol/g creatinine/24-hr) (p<0.001). There was a negative correlation between erythrocyte magnesium (2.07 +/- 0.62 mmol/L) and urine magnesium (7.12 +/- 2.18 mmol/g creatinine/24-hr) (r=-0.68 p<0.01) in diabetic children. Magnesium tolerance test showed that percentage of retained magnesium in diabetic children (66 +/- 26%) was significantly higher than in controls (16 +/- 7%) (p<0.001). This study is the first study to simultaneously investigate serum, erythrocyte and urine magnesium levels and magnesium tolerance test in newly diagnosed diabetic children. In conclusion, erythrocyte magnesium levels decrease earlier than serum magnesium in diabetic children. The follow-up parameters in diabetics may include the policy of monitoring magnesium status. Erythrocyte magnesium measurement is preferred to serum magnesium. Magnesium tolerance test is a reliable and sensitive method, which may be used as an alternative to erythrocyte magnesium measurement or in combination with it in hospitalized diabetic children.     

Serum IL-1, IL-2, TNFalpha and INFgamma levels of patients with type 1 diabetes mellitus and their siblings

Type 1 diabetes mellitus (DM) develops as a result of autoimmune destruction of the pancreatic beta-cells. The aim of this study was to explore possible associations between serum levels of cytokines, IL-1, IL-2, TNFalpha and INFgamma and metabolic parameters in children with type 1 DM and their non-diabetic siblings to determine whether these cytokines could be indicators of disordered immune regulation. The study population consisted of 41 children with type 1 DM, 32 non-diabetic siblings, and 28 healthy controls. Children with DM were divided into three subgroups: 1) newly diagnosed patients with diabetic ketoacidosis (ND + DKA), 2) newly diagnosed patients without DKA (ND - DKA), and 3) previously diagnosed patients (PD). The highest serum IL-1alpha level was found in the ND - DKA group, which was significant compared to both the ND + DKA (p < 0.05) and the siblings (S) (p < 0.005). IL-2 levels were similar among all groups. The highest TNFalpha level was observed in the ND + DKA group, which was significant against the ND - DKA (p < 0.05), PD (p < 0.001), S (p < 0.05), and control (C) (p < 0.005) groups. TNFalpha concentration in the PD group was significantly lower than those of S (p< 0.005) and C (p < 0.001) groups. The ND - DKA group had the highest INFgamma and this was statistically significant when compared with the S (p < 0.005) and C (p < 0.05) groups. Both the newly diabetics and all diabetics as a group had statistically significantly higher INFgamma levels than both the S (p < 0.01 for both) and C (p < 0.05 for both) groups. In the diabetics as a whole group, TNFalpha showed correlations with INFgamma (r = 0.370, p < 0.05). IL-1 showed correlation with TNFalpha (r = 0.368, p < 0.05) INFgamma (r = 0.796, p < 0.001) and IL-2 (r = 0.862, p < 0.001) in the all diabetics group. IL-2 was correlated with TNFalpha (r = 0.320, p < 0.05) and INFgamma (r = 0.754, p < 0.01) in the all diabetics group. In conclusion, our results suggest that proinflammatory cytokines TNFalpha, INFgamma, IL-1alpha and IL-2 may play important roles alone or in combination in the pathogenesis of type 1 diabetes mellitus.     

Intellectual development of offspring of diabetic mothers

We prospectively evaluated the intellectual development of 33 children who were born to 33 diabetic Japanese mothers and compared them to 34 children born to non-diabetic mothers (controls) during the same period at Kurume University Hospital between 1987 and 1989. Birthweight, maternal age and the infant's age at the time of intelligence testing did not differ significantly between the offspring of diabetic mothers (ODMs) and controls. Tanaka-Binet intelligence scores were significantly lower in the ODMs at 3 years of age than in controls (98.4 ± 17.4 versus 113.4 ± 15.3) (p = 0.0005). No correlation was found between IQ and maternal haemoglobin A_1c levels during pregnancy. Maternal age and infant IQ were inversely correlated in ODMs (p = 0.0298, r = ?0.3984), but no such correlation was demonstrated in the controls. The results indicated that the ODMs may show a poorer intellectual development than those of non-diabetic mothers.     

Increased high density lipoproteins in diabetic children

Serum lipoprotein lipid and apolipoprotein concentrations were determined in 27 diabetic children (5–18 years old) and 13 matched healthy controls. The serum cholesterol concentrations in the diabetics were slightly higher than in the controls (P<0.05) due to a significantly higher level of the high density lipoprotein cholesterol (P<0.01). Also the serum concentration of apolipoprotein A-I, the major protein constituent of the high density lipoprotein fraction, was higher in the diabetic children (P=0.05). There were no significant differences between the groups with regard to the serum triglyceride concentrations or the apolipoprotein C-II and C-III concentrations. Neither the lipoprotein lipid nor the apolipoprotein levels were significantly correlated with variables related to the degree of regulation of the diabetic disease. No obvious explantation, based on the present data, can be given for the increased high density lipoprotein cholesterol concentrations in insulin-treated diabetics in comparison with the healthy children. It is possible, however, that the increased high density lipoprotein cholesterol concentration may be caused by an increased level of insulin in the circulation of insulin-treated diabetic children.     

Brainstem auditory evoked potentials during hypoglycaernia in insulin-dependent diabetic children

Brainstem auditory evoked potentials (BAEP) were studied in 10 type 1 diabetic children during normoglycaemia (5.5 × 0.4mmol/l), hypoglycaemia and in the post-hypoglycaemic state. In addition, BAEP during normoglycaemia in diabetic children were compared with those of an age-, weight- and sex-matched group of healthy control children. No significant differences were observed between all latencies of the diabetic children compared with those of the healthy children during normoglycaemia. During induction of hypoglycaemia a minor ( p < 0.05) prolongation of the inter-peak latency 1-V at a blood glucose concentration of 4.1 × 0.5 mmol/l was observed. This prolongation was not aggravated at glucose nadir (1.7 × 0.3 mmol/l). In conclusion, and in contrast with previous findings in non-diabetic children and in adults with type 1 diabetes, no changes in BAEP were demonstrated during short-term severe hypoglycaemia in diabetic children and only minor transient changes were seen during the initial phase of a standardized induction of hypoglycaemia.     

Changes in attention with hypo- and hyperglycaemia in children with insulin dependent diabetes mellitus

We compared the results of a computerized attention test (TOVA) in 38 children with insulin dependent diabetes mellitus in relation to various spontaneously occurring blood glucose levels. Testing was performed at the following blood glucose levels: <3.3 mmol/l (hypoglycaemia), 3.3–8.3 mmol/l (normoglycaemia) and >8.3 mmol/l (hyperglycaemia) . The attention (sum of errors and response time) varied significantly with the blood glucose level (P=0.002). The highest number of errors of omission and the longest response time was observed during the test run with hypoglycaemia. Age, sex, age at manifestation of the disease, metabolic control and the results of the intelligence test had no significant influence on these results. We found that attention in children with diabetes was significantly reduced compared to TOVA norms especially during mild hypoglycaemia (P<0.001). Irrespective of the blood glucose levels, reaction time and the variability of the reaction time differed significantly between TOVA norms and diabetic children (P<0.01). Conclusion In children with diabetes mellitus a significant reduction in attention was found at mild hypoglycaemia but as well at low normal blood glucose levels. Attention deficits due to transient lowering of blood glucose may therefore occur in diabetic children even before they are aware of hypoglycaemic symptoms. Received: 24 November 1997 / Accepted: 2 March 1998     

Insulin response to glucagon in diabetic children

Glucagon promotes a rapid, short-lasting increase of plasma insulin levels in diabetic children. Following intravenous injections of 5 and 20 g/kg, every child responds to the stimulus. Even the smallest load used in these studies, 1 g/kg, still raises the insulin plasma concentration in 2 out of 4 diabetics. Compared to the responses of non-diabetic controls, lower insulin maxima, and a shorter duration of plasma insulin elevation above baseline levels are observed in diabetic children, in spite of their higher blood sugar values. Peaks are measured after 1 to 2 min in the diabetics, at 3 min in the controls. Therefore, it seems likely that the mechanism of insulin release is undisturbed in the diabetics, while their pancreatic insulin reserve is severely impaired.Differences of the clinical courses of overt diabetes in childhood (immediate insulin requirements (D(i)) versus temporary compensation on diet only (D(d)) seem to be due to variations of the endogenous insulin output. Glucagon-induced insulin release, and even more the insulin/glucose ratio following stimulation represent adequate and objective criteria for these differences.Supported by a grant from the Deutsche Forschungsgemeinschaft, Bad Godesberg.     

Red blood cell electrolyte changes in patients with juvenile diabetes mellitus

The sodium and potassium concentrations of the red blood cells and the serum were investigated in 21 children with diabetes mellitus. Measurements were made prior to and 1 and 2 hours following insulin administration. Before insulin treatment, the sodium level in the red blood cells of the diabetes patients was significantly higher that the control level, while the potassium level was significantly depressed. These differences were not observed 1 and 2 hours following insulin administration. Attention is drawn to the rapid and extensive electrolyte changes in the red blood cells of diabetics in response to insulin. The potassium content of the serum of the diabetics was significantly decreased by insulin administration. No correlation was found between the electrolyte levels and the fasting blood glucose levels. A weak negative correlation (p less than 0.02) was observed between the potassium content of the red blood cells and the duration of the illness. The pathogenetic, diagnostic and therapeutic implications of the results are discussed.     

Sports and diabetes in children and adolescents

The triad of insulin, diet and exercise has been the basis for treatment of diabetes for several decades. However, the choice of sporting activities for young diabetics requires an understanding of: a) the energy metabolism and the adaptation to physical activity in the healthy; b) the metabolic adaptation during physical activity in the diabetic child; and c) the practical recommendations concerning diet and insulin that have to be learned by the children themselves. The healthy child utilises immediately available substrates, such as ATP and creatine phosphate in much the same fashion as the adult. However, the capacity for anaerobic degradation of glycogen and glucose seems limited in the muscles of children relative to that of adults. Consequently, the adaptation to resistance exercise should be undertaken with prudence in children and adolescents. The release of insulin tends to decrease during effort. Diverse hypotheses have been proposed to explain this phenomenon. However a low concentration of insulin is required: insulin is said to play a "permissive" role. In diabetic children, an adequate insulin therapy is required to allow the full benefit of muscular activity on glucose assimilation and to reach the same level of physical performance as the non-diabetic. In the case of insufficient metabolic control, exercise can provoke severe hypoglycaemic episodes, even after muscle activity has ceased, or increase glucose levels and lead to ketoacidosis. Regular physical training induces a reduction in postexercise proteinuria measured in diabetic adolescents but its role in metabolic control remains controversial.(ABSTRACT TRUNCATED AT 250 WORDS)     

Serum soluble endothelial-cell specific adhesion molecules in children with insulin-dependent diabetes mellitus

Endothelial-cell specific adhesion molecules are reported to be elevated in patients with diabetes mellitus and related to diabetic vascular complications. We studied serum concentrations of soluble intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), endothelial-leukocyte adhesion molecule (sE-selectin) in 30 healthy children and 35 children with type 1 diabetes without symptomatic vascular complications. sE-selectin levels were higher in diabetics than in controls (p < 0.001). sVCAM-1 and sICAM-1 levels were not different between the groups (p > 0.05). In seven newly diagnosed diabetics with ketoacidosis, concentrations of these molecules were not different before and after one month of insulin therapy (p > 0.05). In the combined group, only sE-selectin was correlated positively with serum glucose, HbA1c (r = 0.3, p < 0.05 for both) and negatively with C-peptide levels (r = -0.4, p < 0.05). In diabetic children without symptomatic vascular complications, sE-selectin but not sICAM and sVCAM levels was elevated; this finding might reflect ongoing endothelial-cell activation rather than endothelial damage.     

Changes in blood glucose,glycosylated hemoglobin and hemoglobin-oxygen affinity following meals in diabetic children

As the concentration of total glycosylated hemoglobin (Hb A_I) may be responsive to acute fluctuations in blood glucose, and as Hb A_Ic is known to have increased in vitro oxygen affinity, we evaluated whether acute variations in Hb A_I were accompanied by changes in hemoglobin-oxygen affinity in insulin-dependent diabetic children.Blood glucose, Hb A_I, hemoglobin-oxygen affinity and related parameters were determined in 42 diabetic children in the fasting state before insulin and 6 h later following their usual insulin dose and meals. During the 6-h period significant increases occurred in the mean concentrations of blood glucose and Hb A_I (P<0.001), and a correlation was present between the increment in blood glucose and that in Hb A_I (r=0.62, P<0.001). The mean hemoglobin-oxygen affinity also increased, but this change was found to be unrelated to the increase in Hb A_I. The increment in hemoglobin-oxygen affinity correlated with an increment in blood pH (r=0.49, P<0.001). Hemoglobin concentration, hematocrit, and red cell 2,3-DPG content were significantly elevated in the diabetic children compared to 30 healthy children (P<0.005), and in the diabetic children the Hb A_I correlated with hemoglobin, hematocrit and erythrocyte count (P<0.05).The present study indicates that in juvenile diabetics rapid fluctuations may occur in Hb A_I which are glucose-dependent, whereas the simultaneous minor change in hemoglobin-oxygen affinity appears to be pH-dependent.     

Apolipoproteins and Lipoproteins in Children with Type I Diabetes: Relation to Glycosylated Serum Protein and HbA1

ABSTRACT. Serum levels of cholesterol (C), triglycerides (TG), lipoprotein-C and apolipoproteins (apo) A-I, A-II and B were measured in 30 children with type I diabetes mellitus (16 boys, 14 girls, aged 11–14 years) and in 26 healthy controls (15 boys, 11 girls, aged 10–13 years). For 19 diabetics controls matched for age, sex and relative body weight were selected. The diabetic patients were considered to be in fair metabolic control according to HbA₁ levels and glycosylated serum protein concentrations. Mean serum apo A-I, A-II and B, C, TG, low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) did not differ significantly between diabetic and nondiabetic children. Very low density lipoprotein cholesterol (VLDL-C) was significantly higher in diabetic children than in controls. Serum C and LDL-C levels showed close univariate linear correlations with glycosylated serum protein (LDL-C: r =0.53, p <0.01, C: r =0.58, p <0.01) in diabetics. The ratio LDL/HDL-C was significantly correlated to HbA₁ levels ( r =0.47, p <0.01). By canonical and multiple linear correlation analysis significant relations of a selected set of variables concerning the control and therapy of diabetes (serum glucose, HbA₁, glycosylated serum protein, insulin dose) with a set of lipoprotein variables (C, TG, VLDL-C, HDL-C, LDL-C, apo A-I, A-II, B) could be demonstrated. From these data we conclude that significant relations between atherogenic serum lipids and lipoproteins (C, LDL-C) and the degree of metabolic control exist in diabetic children, even in the absence of marked dyslipoproteinemia. The close relation of LDL-C and total C with glycosylated serum protein in the diabetics might be due to glycosylation of LDL .     

Serum Levels of Glycated Albumin in Non-Diabetic and Insulin-Dependent Diabetic Children

The serum levels of glycated albumin (GA) in 83 non-diabetic children and 26 children with insulin-dependent diabetes mellitus (IDDM) were measured by high-performance liquid chromatography (HPLC). In non-diabetic children over one year, the GA levels were found to be uninfluenced by age, while the fructosamine (FRA) levels increased with age. The mean level of GA in IDDM children was 39.1±9.1%, which was significantly higher than in non-diabetic children with values of 16.1±.1% (p<0.01). The GA levels of non-diabetic and IDDM children did not overlap, whereas their FRA levels did overlap. The GA levels correlated with HbAlc levels (r=0.74, p<0.01) and FRA levels (r=0.66, p<0.01) in IDDN children. The GA levels were more closely correlated than the FRA levels with the blood glucose two and three weeks previously. Thus, the GA level is a useful indicator of shortterm control in diabetes mellitus.