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Carnitine deficiency in children and adolescents with type 1 diabetes

Carnitine is essential for the lipid and carbohydrate metabolism, and is known to increase the sensitivity of the cells to insulin.// The use of glucose by the peripheral tissues and proper metabolic control in Type 1 diabetes has potential impact on long-term complications.

In diabetes, the metabolism of carbohydrate and fat is abnormal and an association between the proper metabolic control and the development of complications is widely recognized. Decreased plasma carnitine levels have already been reported in patients with type 2 diabetes and an underestimated role of carnitine in the clinical course and the complications has been suggested.

The development of microvascular complications is uncommon during childhood and adolescence; however, the principles of proper metabolic control must be imparted from the onset. Recognition of carnitine deficiency in these patients may thus have therapeutic implications.

In a study published in vol 18 (5) of Journal of Diabetes and its Complications, researchers from the Department of Paediatrics, University of Crete, Greece investigated the carnitine levels in children and adolescents with Type 1 diabetes.

The plasma total, free, and acylcarnitine levels in 47 children and adolescents with type 1 diabetes were determined by a radioisotopic assay and compared to the values of a series of anthropometric measurements and metabolic parameters, including blood glycosylated hemoglobin Alc, serum cholesterol and triglycerides, and urine microalbumin levels.

The results from the study confirm the relative deficiency of total and free carnitine in children and adolescents with Type 1 diabetes. Furthermore, clear evidence is provided that this decrease is time related and that patients with long-standing Type 1 diabetes are prone to carnitine alterations. Larger studies are needed in order to draw firm conclusions and to explore a possible role, if any, of supplementary carnitine in the
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