P-114: Autoimmunity pattern in type 1 diabetes patients in northern himalayan state of Himachal Pradesh, India and comparison of glycemic control in patients with T1D and other associated autoimmunity

Introduction

Type 1 diabetes is an autoimmune disease and its presentation differs in patients. Most patients present with varied symptoms like polyuria and Polydipsia. The vast majority present in life threatening conditions like Diabetes ketoacidosis. This study will compare symptomology with autoimmune pattern of Type 1 diabetes and its other associated autoimmunity.

Objectives

1 Comparison between autoimmunity pattern (GAD 65, TTGA, TFT with anti TPO antibodies, TTGA) and presenting symptomatology (DKA, Polyuria, Polydipsia etc.) 2 Effect of DSME on HbA1C and glycemic control

Methods

To diagnose all patients of T1D on the basis of ISPAD guidelines. All patients to undergo a detailed protocol, (History, examination and autoimmunity panel). Patients are admitted and provided insulin from hospital and DSME (Parents/attendants/admitted patient) To compare the association between autoimmunity and presenting symptoms to hospital (DKA/Polyuria/Polydipsia, etc.).

To compare effect of DSME on HBA1C and glycemic control.

To provide Diabetes self-management Education (insulin use & self-care) to patients with T1D. DSME is provided to all patients by dedicated staff which ensures utilization of insulin and adequate glycemic control of diabetes

Results

140 patients were enrolled in study and autoimmunity pattern was determined. GAD 65, TPO, TTGA were done (IAA and IA2 couldnt be done because of cost factor only few affording patients could get it done).

Patients were divided into three categories (T1D, T1D and AITD, T1D with coeliac disease) All three categories were studied and their autoimmune pattern was compared with presenting symptoms, HbA1C levels and glycemic control followed by reassessment at 3 months.

GAD positive - 72

TTGA positive- 22

TPO positive - 18

T1D in combination with other associated autoimmunity have poor control as compared to only T1D patients.

Conclusions

Mapping of the autoimmune pattern of T1D patients for evaluation and poor control of T1D patients with other associated autoimmunity