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Double diabetes: A new paradigm in diabetes care

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Aim: Estimation of the prevalence of double diabetes which is the coexistence of metabolic syndrome and Type 1 diabetes in a busy diabetic outpatient clinic. Methods: Thirty patients with type 1 diabetes were assessed to see if they fulfilled the criteria for the metabolic syndrome according to the criteria of the international diabetes federation. A family history of type 2 diabetes was sought as this is considered an important part of double diabetes. The diagnosis of Type 1 diabetes was based on clinical history and presence of anti-Gad antibodies. Results: Thirty patients with Type 1 diabetes were studied (mean age of 41 years, age range 29 to 64 years; 19 males and 11 females). Out of the 30 patients; raised waist circumference was seen in 5, hypertension was present in 9, raised triglycerides was seen in 4 people and low HDL in 5 people. The metabolic syndrome criteria was fulfilled in 4 people (13%). Out of seven patients with a family history of Type 2 diabetes, the metabolic syndrome criteria was fulfilled in 2. Conclusions: Our survey identified 4 people with type 1 diabetes and features of metabolic syndrome suggesting a diagnosis of double diabetes. It would appear from the data presented that the combination of waist circumference and HTN appear to be the most consistent indicators of this condition. These people have a higher risk of both micro and macrovascular complications and need appropriate preventive and broad management strategy for their metabolic syndrome and insulin resistance.