Relative carnitine insufficiency in children with type I diabetes mellitus
S. C. Winter, M. Simon, E. M. Zorn, S. Szabo-Aczel, W. H. Vance, T. O'Hara and L. Higashi
Department of Pediatrics, University of California, San Francisco.
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 A1c,
and a urine sample for levels of ketones and glucose, we found 13 children
were deficient of free carnitine (less than 20 mumol/L) and 30 had elevated
acyl carnitine levels (greater than 11 mumol/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.
