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Adolescents and young adults with type 1 diabetes display a high prevalence of endothelial dysfunction
Author(s) -
Scaramuzza A E,
Redaelli F,
Giani E,
Macedoni M,
Giudici V,
Gazzarri A,
Bosetti A,
De Angelis L,
Zuccotti G V
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12877
Subject(s) - medicine , endothelial dysfunction , hyperaemia , type 2 diabetes , diabetes mellitus , glycated hemoglobin , insulin , body mass index , endocrinology , type 1 diabetes , blood pressure , cardiology , blood flow
Aim Little is known about endothelial function in adolescents with type 1 diabetes, and we evaluated endothelial dysfunction, using reactive hyperaemia peripheral arterial tonometry ( RH ‐ PAT ). Methods This prospective, observational, 1‐year study focused on 73 adolescents with type 1 diabetes, using multiple daily injections or continuous subcutaneous insulin infusion. The subjects were assessed using RH ‐ PAT , body mass index, blood pressure, fasting lipid profile, glycated haemoglobin, insulin requirements and hours of physical exercise per week. Results Endothelial dysfunction was observed in 56 patients (76.7%), with lower mean RH ‐ PAT scores (1.26 ± 0.22 versus 2.24 ± 0.48, p < 0.0001) and higher glycated haemoglobin values at baseline (8.27 ± 1.24% versus 7.37 ± 0.54%, p = 0.006) and as a mean of the whole period since diagnosis (8.25 ± 1.22% versus 7.72 ± 0.82%, p = 0.034). A higher percentage of patients with endothelial dysfunction showed abnormal cardiac autonomic tests (p = 0.02) and were more sedentary, exercising <4 hours a week, than patients with normal endothelial function. After follow‐up in 64/73 patients, we observed endothelial dysfunction in 81.8% of patients, despite a modest improvement in glycated haemoglobin. Conclusion Adolescents with type 1 diabetes displayed evidence of endothelial dysfunction. Good metabolic control (glycated haemoglobin ≤7.5%, 58 mmol/mol) and regular physical activity of at least 4 h a week might be protective.