ESPE Abstracts

Objective: To investigate the prevalence of elevated arterial stiffness and associations to known and potentially novel risk factors in a modern European technology-based cohort of children and adolescent with type 1 diabetes.

Research Design and Methods: Cross-sectional study including 127 children recruited from Pediatric Diabetes Departments across Eastern Denmark between May 2022 and January 2024. Arterial stiffness was assessed as carotid femoral pulse-wave-velocity (cfPWV) using the Sphygmocor XCEL system. Unadjusted and adjusted linear regression models explored associations between cfPWV and other risk factors. Adjustment included age, sex, diabetes duration, time-in-range, Hba1c, waist-height ratio, LDL-cholesterol, and mean arterial pressure.

Results: Median (IQR) age was 14.2 years (12.0, 16.4), diabetes duration was 4.7 years (2.7, 8.4), Hba1c level was 7.0% (6.5, 7.9), (53 mmol/l: 48-63), time-in-range was 63% (53-75) and 52% were male. The majority were treated with continuous-subcutaneous-insulin-infusion (82%), and all (except two) used continuous-glucose-monitors. The prevalence of elevated arterial stiffness (cfPWV z-score over 90^th percentile) was 16%. Unadjusted analyses demonstrated higher cfPWV was associated with longer diabetes duration, higher age, Hba1c, mean arterial pressure and liver stiffness, and lower time-in-range and insulin sensitivity. Higher cfPWV remained associated with higher age (standardized β (CI 95%):0.38 (0.27, 0.48); P <0.001) and lower time-in-range (-0.15 ((-0.26), (-0.03)); P <0.011) after adjustment.

Conclusions: Despite modern treatment technology and better overall metabolic control, children and adolescents with type 1 diabetes present with a high prevalence of elevated arterial stiffness. Higher arterial stiffness was associated with higher age and lower time-in-range, independent of other risk factors including Hba1c.