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Characterization of type 1 diabetes patients with special reference to Growth & Body Composition


Funded By: Intramural Study
Month & Year of Commencement:  May 2009
Current Status:  Ongoing

Principal Investigator: Dr.C.S.Yajnik, Director, Diabetes Unit, KEM Hospital & Research Centre,Pune,India

Co-Investigator: Dr. Kalpana Jog, Dr. Koumudi Godbole

» Background
» Objectives

» Methodology and Design
» Current status


Background


Type 1 diabetes affects growth and development of an individual especially with onset during childhood. This might be further influenced by genetic make up and environmental factors.

  • Diabetes Unit KEMHRC has been running type 1 diabetes clinic for almost two decades. The onset of disease is often in childhood & it affects diet, physical activities & schooling of children.

  • Since Indians are genetically predisposed to type 2 diabetes and environmental changes including diet and lifestyle have been changing significantly over the years, this study may provide us opportunity to observe early features of type 2 diabetes/cardio-metabolic risks in individuals with type 1 diabetes (Double diabetes).

  • There is anecdotal evidence that the affected children, especially girls tend to be shorter & many of them have delayed puberty. There is ample evidence in literature that patients with type 1 diabetes have multi-systemic affection including renal, cardiac, opthalmic & CNS involvement.

  • We feel it is important that Indian type 1 diabetes patients should be appropriately characterized in order to optimize their medical management & offer them necessary surveillance to prevent or early detection of the disease complications.

  • As a part of this study we are also exploring the knowledge, attitude and practices of families with type 1 diabetes affected individuals which might help in imparting appropriate health education and improving compliance.




Objectives

  • To explore features of double diabetes: features of type 2 diabetes/ metabolic syndrome co-existing with type 1 diabetes
  • To assess reproductive growth in girls >12 years with type1 diabetes

 



Methodology and Design

This is a Case-control study

  • Cases: Girls with type 1 diabetes with their parents

  • Controls: Healthy girls of matched age, sex, socio-economic status and without any acute or chronic illness



Current status
  • Enrollment, appointment & consent

  • Biochemistry – a. Blood samples : HbA1C,BSL: F/PP, Lipid profile, Haemogram with RBC indices (Aliquots stored at -80oC for DNA and any further biochemistry) b. Urine samples: Routine, Ketones, Microalbuminuria (Samples stored at -80oC for any future assays)

  • Recording medical as well as family history up to three generations

  • Clinical examination including general/ systemic examination, Tanner staging and dysmorphology

  • Anthropometry: wt, ht, head circumference, BMI, waist-hip ratio (WHR) of cases & their parents and controls

  • DXA

  • Ultrasound for uterus/ovaries, eye and hearing check up for all cases as a part of routine follow up



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