ESPE Abstracts

Background: Diurnal glycaemic variability has a direct impact on the formation of chronic complications of type 1 diabetes mellitus (T1DM) in children.

Aim: To clinically assess the function of the cardiovascular system depending on the diurnal glycaemic variability in children with T1DM.

Material and methods: The study involved 65 children (30 girls and 35 boys) aged 4–17 years (mean age – 11+0.4 years old) with T1DM duration from 1 to 14 years (mean duration of the disease 4+0.3 years old) in the Endocrinology Centre of CPH No. 2 (Tver, Russia). The subjects underwent clinical examination: they had HbA1c testing, 24-h blood glucose monitoring and electrocardiography (ECG). Depending on the glycemic variability parameters, the subjects were assigned to one of the two groups: group 1 – glycemic variability <5 mmol/l per day (3.7+0.26 mmol/l, n=15) and group 2 – >5 mmol/l per day (7.8+0.30 mmol/l, n=50).

Results: The study has revealed significant increase in HbA1c in group 2 (9.5+0.29%) compared to group 1 (8.4+0.54%, P<0.05). The ECG analysis showed a significant increase in the frequency of sinus arrhythmia in group 2 (35%) compared to group 1 (14%, P<0.01). There was no significant difference in the incidence of tachycardia between the two groups. In group 2 we found a significantly higher incidence of early repolarization syndrome compared to group 1 (25 and 7%, respectively, P<0.05), wandering atrial pacemaker (7 and 0%, respectively, P<0.01), second degree sinoatrial block (7 and 0%, respectively, P<0.01).

Conclusions: Diurnal glycaemic variability affects the function of the cardiovascular system in children with T1DM, which requires a differentiated approach to monitoring and rehabilitation.