Children with Type 1 diabetes have early signs of atherosclerosis

6 September 2010

MedWire News: Study results show that children with Type 1 diabetes have significantly increased carotid intima media thickness (IMT), an early sign of atherosclerosis, compared with their nondiabetic peers.

Researchers say this was despite the diabetic children having short disease duration, intensive insulin therapy, reasonable glycemic control, and no signs of microvascular disease.

Hanna Dis Margeirsdottir (University of Oslo, Norway) and colleagues recruited 314 children, aged 8 to 18 years, with Type 1 diabetes from the Health Region South-East in Norway, to participate in this study. A total of 118 aged-matched healthy controls were also enrolled for comparison purposes.

The mean age of the participants was 13.7 years, diabetes duration was 5.5 years, and glycated hemoglobin (HbA1c) was 8.4%. All were on intensive insulin treatment with either injections, pumps, or both.

As reported in the journal Diabetes Care, the team found that the diabetic children had significantly greater carotid IMT than nondiabetic children. In total, 19.5% and 13.1% of diabetics had a carotid IMT above the 90th and 95th centile of healthy controls, respectively.

When divided by gender, diabetic boys (n=155) had significantly higher mean carotid IMT than nondiabetic boys (n=53), at 0.46 versus 0.44 mm. However, the difference in mean carotid IMT between diabetic and nondiabetic girls was nonsignificant.

The authors also assessed carotid distensibility, compliance, and wall stress, but found no significant differences between the groups. No signs of atherosclerotic plaque were seen in the children.

“The results from this study indicate that children and adolescents with Type 1 diabetes have more atherosclerotic changes than healthy control subjects… and these changes are most prominent among boys,” write the researchers.

However, they add: “This is a baseline examination in a longitudinal prospective study, and though the results indicate more advanced atherosclerotic development in the diabetic group, it is reassuring that the changes are small in this group of young patients at this early stage of the disease.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

Diabetes Care 2010; 33: 2043–2048