ESPE Abstracts

Hypertension is a frequent chronic pathology in young diabetics. The association of diabetes and hypertension represents a high risk of morbidity and premature cardiovascular mortality. The aim of this study was to evaluate the frequency of hypertension in young diabetics and to assess the associated morbid factors.

Patients and Methods: 357 diabetics aged 3 to 27 years (mean age: 10 years), were followed at the Children's Hospital over a period ranging from 5 to 14 years (mean: 5 years). High blood pressure is defined as a BP greater than 140 mmHg and a minimum BP greater than 90 mmHg, taken in the supine position and confirmed on a second examination.

Results: Of 357 Children, 25 had hypertension with a maximum BP between 140 and 220 mmHg (mean: 154±14 mmHg) and a minimum BP of 90 to 110 mmHg (mean: 94±4 mmHg). The hypertensive diabetics were aged between 11 and 22 years (mean age: 16±7 years) at the time of diagnosis with a diabetes duration of 4 to 14 years (mean: 7±3 years). Their metabolic control assessed by glycated hemoglobin ranged from 6.4 to 14.3% (mean: 10.4±2.9 %). The mean body weight was 23.15 Kg/m2 (range: 19.91-29.68 Kg/m2). 5/25 hypertensive patients were obese. In 8 hypertensive diabetics, the lipid profile was disturbed. We observed a significant increase in total cholesterol (P<0.001), -LDL-cholesterol (P<0.001), triglycerides (P<0.001) and ApoB (P<0.01) compared to the physiological values of the diabetics and to the values of non-hypertensive control subjects of the same age. Microalbuminuria affects 41/357 subjects and is observed with an increased frequency 68% (17/25) in young hypertensive subjects. The average proteinuria was 2.67 g/l. Subsequently, other complications (nephropathy, retinopathy and neuropathy) exist with a high frequency (48%) in hypertensive diabetics. Converting enzyme inhibitors prescribed in 13/25 diabetic children could prevent the development of degenerative complications by treating hypertension.

Conclusion: This work confirms the relationship between hypertension and diabetic complications and encourages early detection in all young diabetics.