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Susan C. Winter, MD; Mary Simon, MD; Elinor M. Zorn, MD; Stefan Szabo-Aczel, MD; W. Hugh Vance, PhD; Timothy O'Hara; Linda Higashi

Am J Dis Child. 1989;143(11):1337-1339.

Abstract
• Recognizing the similarity of type I diabetes mellitus to inborn errors of metabolism that have responded to carnitine therapy, we initiated a study of 54 children with type I diabetes mellitus. Examining a fasting blood sample for levels of carnitine, glucose, and glycosylated hemoglobin A_1c, and a urine sample for levels of ketones and glucose, we found 13 children were deficient of free carnitine (<20 µmol/L) and 30 had elevated acyl carnitine levels (>11 µmol/L). Statistical tests confirmed a significant difference between the diabetic population and normal population for reduced free carnitine, elevated acyl carnitine, and an elevated ratio of acyl carnitine to free carnitine. Also, a significant correlation was found between the levels of urine glucose and ketones and the level of acyl carnitine. Our data indicate that carnitine deficiency and relative insufficiency may be an overlooked component in the management of diabetes.

(AJDC. 1989;143:1337-1339)

Author Affiliations
From the Department of Pediatrics, University of California, San Francisco, and Medical Genetics/Metabolism, Valley Children's Hospital, Fresno, Calif (Drs Winter, Simon, and Zorn); and Metabolic Research and Analysis Inc, Fresno (Drs Szabo-Aczel and Vance and Mr O'Hara and Ms Higashi).

Footnotes
Accepted for publication July 10, 1989.

Reprint requests to Metabolic Research and Analysis, 3150 E Shields No. 104, Fresno, CA 93724 (Dr Winter).

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