POOR METABOLIC CONTROL, EARLY AGE AT ONSET, AND MARGINAL FOLATE-DEFICIENCY ARE ASSOCIATED WITH INCREASING LEVELS OF PLASMA HOMOCYSTEINE IN INSULIN-DEPENDENT DIABETES-MELLITUS - A 5-YEAR FOLLOW-UP-STUDY

In a previous study, we showed that diabetic patients exhibited signif icantly increased concentrations of total plasma homocysteine (tHcy), but not until the onset of nephropathy. It was suggested that the hype rhomocysteinaemia might contribute to the accelerated atherosclerotic process in diabetic patients. In the present study, we have analysed t he main determinants of plasma homocysteine (i.e. serum cobalamin, blo od folate and serum creatinine), and also some other parameters relate d to diabetes mellitus, such as medical history, metabolic and renal q uantities, on two occasions with a 5-year interval in 50 patients with insulin-dependent diabetes mellitus, in order to further elucidate th e relation between plasma tHcy and diabetes mellitus. The result of th e present study shows that diabetic patients with the lowest age at on set and with the poorest metabolic control are those most prone to a r apid increase in plasma tHcy concentration. The increment in plasma tH cy concentration in this group of patients may at least partly be expl ained by a marginal deficiency of blood folate concentrations.