Metabolic control,glycosylated haemoglobin and high density lipoprotein cholesterol in diabetic children

The present study on 28 diabetic and 38 non-diabetic children was conducted to extend information on the usefulness of HbA_Ia-c measurement in assessing the effectiveness of metabolic control, and to investigate to what extent HbA_Ia-c and blood glucose reflect changes in plasma cholesterol, especially high density lipoprotein cholesterol. Since the activities of serum lysosomal hydrolases are reported to be increased in diabetic patients, it was of interest to examine the changes in serum N-acetyl--D-glucosaminidase in relation to HbA_Ia-c.Both fasting blood glucose and daily urinary glucose excretion were found to be positively related to HbA_Ia-c. The poorly controlled diabetic children exhibited the highest percentage of glycosylated haemoglobins. The total cholesterol and HDL-cholesterol content—as well as the activity of N-acetyl--D-glucosaminidase in the plasma—were also found to be directly related to the proportion of HbA_Ia-c. The measurement of glycosylated haemoglobins thus appears to be an important and useful aid in determining the effectiveness of long term control in juvenile diabetes. The interesting findings that HDL-cholesterol was significantly higher in diabetic children than in agematched controls, and that it was positively related to the fasting blood glucose and glycosylated haemoglobins, supports recent suggestions that there is an essential difference in plasma HDL-cholesterol between juvenile and adult onst diabetes. This fraction of plasma cholesterol, which represents a negative risk factor of coronary atherosclerosis, was significantly higher in the diabetic children than in patients with adult-onset diabetes.Supported by the Scientific Research Council, Ministry of Health, Hungary (0701)