**7. References**


those having microalbuminuria (Dullaart et al., 1989b; Dullaart et al., 1991). This augmented CETP activity may explain the increase in free cholesterol/ triglycerides ratio within VLDL and its decrease within HDL. Some studies have shown a positive correlation between CETP activity and hyperglycemia (Ritter & Bagdade, 1994; Chang et al., 2001). However, the main factor which is likely to be responsible for increased CETP activity, in type 1 diabetes, could be peripheral hyperinsulinemia secondary to the subcutaneous route of insulin administration. Indeed, peripheral hyperinsulinemia has been shown to be responsible for increased lipoprotein lipase activity in patients with type 1 diabetes (Nikkilä et al., 1977) and it has been reported that lipoprotein lipase, in presence of VLDL, enhances CETP activity (Sammett & Tall,1985; Pruneta et al., 1999). Moreover, it has been shown, in patients with type 1 diabetes, that the increase in both lipoprotein lipase and CETP activities was abolished when insulin was administrated intraperitoneously with implantable insulin pumps, mimicking the physiologic portal route or after pancreatic graft (Bagdade et al.,

Increased PLTP activity has been reported in patients with type 1 diabetes (Colhoun et al., 2001). In this study, PLTP activity was positively correlated with CETP activity, LDLcholesterol and HDL-cholesterol (Colhoun et al., 2001). The reasons and consequences of

In conclusion, quantitative lipid abnormalities are observed in patients with poorly controlled type 1 diabetes (increased triglyceride and LDL-cholesterol levels) or with microor macroalbuminuria (increased triglycerides and LDL-cholesterol, decreased HDLcholesterol). Patient with optimally controlled type 1 diabetes show normal or slightly decreased triglycerides and LDL-cholesterol levels and sometimes increased HDLcholesterol levels. Qualitative abnormalities of lipoproteins are observed in patients with type 1 diabetes, even in good glycemic control. These abnormalities are not fully explained by hyperglycemia and may partly be due to peripheral hyperinsulinemia associated with the subcutaneous route of insulin administration. The exact consequences of these qualitative lipid changes on the development of cardiovascular disease in type 1 diabetes

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1994; Bagdade et al., 1996).

**6. Conclusion** 

are still unknown.

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**4** 

*Ukraine* 

**Prevalence of Type 1 Diabetes Correlates** 

**and with Autoimmune Process Against Glutamic Acid Decarboxylase in Adults** 

Mykola Khalangot1, Vitaliy Gurianov2, Volodymir Kovtun1, Nadia Okhrimenko1, Viktor Kravchenko1 and Mykola Tronko1

> *1Komisarenko Institute of Endocrinology and Metabolism Academy of Medical Sciences, Kiev*

> > *2National Medical University, Donetsk,*

**with Daily Insulin Dose, Adverse Outcomes** 

The territorial differences in the prevalence of type 1 diabetes mellitus (T1D) around the world were previously reported (Amos et al., 1997; Green & Patterson, 2001; Lévy-Marchal, 2001), but the data were based on the study of juvenile T1D epidemiology, i.e., in patients diagnosed with T1D before the age of 15 years. These data became the basis for the epidemiological evaluation of the whole T1D patient population. With the relatively limited number of children with T1D within the current territory, less effort is required for data gathering. Besides, as the age increases, it becomes more difficult to relate a diabetic condition to a certain diabetes type (Keen, 1998), thus, making it impossible to directly use the diabetes-type data obtained from Primary Care. In modern epidemiological studies, the key data concern the age at the time of the diagnosis—patients who were diagnosed before

European researchers have proved that the epidemiological characteristics of T1D in children significantly differ from that in young adults (Kyvik et al., 2004). Therefore, studying the peculiarities of T1D in adults is a major concern. Furthermore, data on the number of diabetic patients usually found in the reports of the healthcare system are unstructured according to the history of the disease, and cannot be a source of epidemiological information on patients suffering from T1D. Owing to the development of the Diabetes Register in Ukraine, it has become possible to conduct analytical comparisons

The Diabetes Register contains individual, structured information on the disease history, and has already been used in some epidemiological studies (Khalangot et al., 2009a;

the age of 30 years and are insulin-treated, are considered to suffer from T1D.

and further studies on almost all the T1D adult populations.

**1. Introduction** 

**1.1 T1D epidemiology in adults** 

**1.2 Diabetes Register** 


Vergès B. (2001). Insulin sensitiviy and lipids*. Diabetes Metab*; 27: 223-7.

