Association of Thiamine Status with Clinical Severity and Insulin Requirements in Children with Type 1 Diabetes Mellitus
Keywords:
Thiamine, Type 1 Diabetes Mellitus, Diabetic Ketoacidosis, Insulin Requirement, Pediatric EndocrinologyAbstract
Background
Thiamine (vitamin B1) is a crucial coenzyme involved in glucose metabolism. Deficiency has been observed in patients with diabetes mellitus, particularly during acute decompensations such as diabetic ketoacidosis (DKA). This study investigates thiamine status in children with Type 1 Diabetes Mellitus (T1DM) and explores its association with clinical presentation, glycemic indices, and insulin requirements.
Methods
A cross-sectional observational study was conducted among 35 children with T1DM, including both newly diagnosed cases with DKA and those with established disease. Clinical data, glycemic parameters, and serum thiamine levels were recorded. Thiamine levels were measured using high-performance liquid chromatography (HPLC). Correlation analysis was performed between thiamine and clinical variables, including insulin dose and glycemic control.
Results
Thiamine deficiency was observed in 60% of the study cohort, with a higher prevalence in children presenting with DKA (72.7%) compared to those without DKA (54.2%). Mean HbA1c and random blood sugar levels were significantly higher in the DKA group (13.03% and 335.7 mg/dL, respectively) than in the non-DKA group (7.33% and 216.4 mg/dL; p< 0.01). Thiamine levels showed no significant correlation with HbA1c, insulin dose, or disease duration. However, HbA1c was inversely correlated with daily insulin dose (r = –0.412, p< 0.05).
Conclusions
Thiamine deficiency is common in pediatric T1DM, especially in acute DKA presentations. While no direct association with insulin requirement was found, findings highlight the need for routine nutritional screening in this population. Larger studies are needed to assess the potential role of thiamine supplementation in glycemic management
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