EARLY SIGNS OF ATHEROSCLEROSIS IN DIABETIC CHILDREN ON INTENSIVE INSULIN TREATMENT: A POPULATION-BASED STUDY.
- Hanna Dis Margeirsdottir, MD ()1,2,3,
- Knut Haakon Stensaeth, MD4,
- Jakob Roald Larsen, MD3,
- Cathrine Brunborg, MSC5 and
- Knut Dahl-Jørgensen, MD1,2,3
- 1 Pediatric Department Ullevaal, Oslo University Hospital, Oslo, Norway
- 2 Faculty of Medicine, University of Oslo, Oslo, Norway
- 3 Oslo Diabetes Research Centre, Oslo, Norway
- 4 Radiology Department Ullevaal, Oslo University Hospital, Oslo, Norway
- 5 Centre for Clinical Research Ullevaal, Oslo University Hospital, Oslo, Norway
Objective: To evaluate early stages of atherosclerosis and predisposing factors in childhood diabetes compared to age- and sex matched healthy control subjects.
Research design and Methods: All children and adolescents with type 1 diabetes, aged 8-18 years in Health Region South-East in Norway were invited to participate in the study (n= 800). 40% (n= 314) agreed to participate and were compared to 118 age-matched healthy controls. Carotid artery Intima Media Thickness (cIMT) and elasticity was measured using standardized methods.
Results: Mean age of the diabetic patients was 13.7 years, diabetes duration 5.5 years and HbA1c 8.4%. 97% were using intensive insulin treatment, 60% insulin pumps. Diabetic patients had more frequently elevated cIMT than healthy controls: 19.5% were above 90th centile of healthy controls and 13.1% above 95th centile (p<0.001). Mean cIMT was higher in diabetic boys compared to healthy controls (0.46mm/SD 0.06mm vs. 0.44mm/SD 0.05mm, p= 0.04) but not significantly so in girls. There was no significant difference between the groups regarding carotid distensibility, compliance and wall stress. None of the subjects had atherosclerotic plaque formation. Although within the normal range the mean values of systolic blood pressure (SBP), total cholesterol, LDL-cholesterol and ApoB were significantly higher in the diabetic patients than in healthy controls.
Conclusions: Despite short disease duration, intensive insulin treatment, fair glycemic control and no signs of microvascular complications, children and adolescents with type 1 diabetes had slightly increased cIMT compared to healthy controls, the differences being more prominent in the boys.
- Received March 19, 2010.
- Accepted May 31, 2010.
- Copyright © American Diabetes Association