Double Diabetes: Insulin Resistance and Metabolic Syndrome in Sudanese Patients with Type 1 Diabetes Mellitus

Background: Double diabetes is a combination of characteristics of type 1 diabetes (T1DM) with metabolic syndrome and insulin resistance. The presence of insulin resistance and the metabolic syndrome are risk markers for macrovascular disease and several studies have found an increased incidence of chronic complications in T1DM patients with double diabetes. Objective: The aim of this study was to determine the frequency of metabolic syndrome and insulin resistance (double diabetes) among T1DM at Gabir Abualiz Hospital, Khartoum State March to November 2020. Method: This was an analytical cross-sectional study conducted at Gaber Abu-Aliz Hospital during the period from August to November 2020, in which 60 T1DM patients were enrolled. Insulin resistance was assessed by estimated glucose disposal rate (eGDR), a low rate correlates with increased insulin resistance. Metabolic syndrome was diagnosed according to the American Heart Association/National Heart, Lung, and Blood Institute criteria. Results: Among 60 patients, the majority were females (81.7%). Metabolic syndrome was found in 27% of patients and abdominal obesity (male WC> 40; female WC> 35 inches) was the component of the metabolic syndrome in 42% of patients. The mean eGDR was 7.88 (2.6-11.6), and 25% had low eGDR levels (most insulin resistance < 4.5). The metabolic syndrome was significantly common among patients with eGDR below 3rd tertile (< 7.8) (P value= 0.000). Moreover, the presence of metabolic syndrome and insulin resistance was significantly associated with obesity, positive family history of T2DM, Lantus use, HbA1c above 9%, retinopathy and nephropathy. Conclusions: The features of double diabetes (metabolic syndrome and insulin resistance) are common among Sudanese T1DM patients. Both metabolic syndrome and insulin resistance were significantly correlated with poor glycemic control, obesity, positive T2DM family history and microangiopathic complications.