Carnitine Levels and Carnitine Supplementation in Type I Diabetes

Hypoglycemia is a clinical marker of carnitine deficiency. Thus carnitine may compound the
risk of hypoglycemia for children on insulin therapy. Currently, one of the limitations in
the management of diabetes is hypoglycemia. The problem of hypoglycemia is of even greater
significance in the pediatric population because children have smaller glycogen stores.

In this study, we will determine if there is a group of children with increased frequency of
hypoglycemia and carnitine deficiency. If there is a correlation from the initial 200
children, we will compare two groups of type I diabetic children between the ages of 7 to 21
years. We will take 20 children with the highest carnitine levels (found in a previous
study) and 20 children with the lowest carnitine levels and perform continuous glucose
monitoring for a 72-hour period. Those who have at least one episode of hypoglycemia will
be asked to undergo repeat testing, after a 2-week period of oral carnitine supplementation.
Supplementation will start at 50 mg/kg body weight for the first week and then increase to
100 mg/kg body weight the second week. Laboratory studies obtained at baseline include
Hemoglobin A1c, carnitine panel, and lipid panel. These will be repeated prior to the
second continuous glucose monitoring. Insulin doses will not be changed between glucose
monitoring sessions. A comparison will be made between individuals with hypoglycemia, to
see if the number of hypoglycemic events has decreased.