ESPE Abstracts

Background: Cardiovascular complications are the leading cause of mortality and morbidity in patients with type 1 diabetes (T1D), and early assessment is crucial. Our study aimed to determine the impact of diabetes on vascular health by monitoring 24-hour ambulatory blood pressure (ABPM) and measuring arterial stiffness (AS) in children with T1D.

Methods: Seventy-four consecutive children with T1D and 68 age and sex-matched healthy controls were included and followed for six months in the study. Demographic data, clinical findings, and laboratory characteristics of the patients were obtained from the patient files. Pulse wave velocity (PWV), augmentation index (Aix) and ABPM were measured using the Mobil-O-Graph device.

Results: Our study included 39 girls and 35 boys with T1D. The mean age of children with T1D was 13.8±3.4 years, and the healthy group was 13.1±3.4 (P = 0.123). The median diabetes duration of the children was 5.8±2.9 years. The average HbA1c for the past year was 8.3±1.7% (5.6-14.2), and the mean insulin dose was 1.0±0.4 (0.6-2.4) U/kg/day. The average diastolic blood pressure (DBP) and mean arterial pressure (MAP) were significantly higher in children with T1D (P = 0.022 and P = 0.001, respectively). The average glomerular filtration rate (GFR) was 115.9±19.9 mL/min/1.73m² in children with T1D and 107.2±11.3 mL/min/1.73m² in the healthy group (P = 0.009). In the diabetes group, the DBP was significantly lower in children with hyperfiltration than with normal GFR (P = 0.006). Males had significantly higher PWV and Aix than females. When both sexes were analysed separately, the daytime Aix values of children with T1D were significantly higher than healthy children (females P = 0.046 and males P = 0.048). PWV all day and night were significantly higher in children with poor glycemic control than those with good glycemic control (P = 0.037 and P = 0.043, respectively). We used multiple regression analyses to assess the impact of independent variables on PWV and Aix values. Our findings indicate that mean values of HbA1c and autoantibody positivity are the key factors influencing PWV, while the Aix values are significantly influenced by gender, age at examination, and weight.

Conclusion: Our study underscores the importance of early evaluation of ABPM and AS to monitor complications. Poor glycemic control emerges as a key factor affecting AS, while the patients’ age also plays a significant role in the development of complications. The significant increase in Aix among certain subgroups of our cohort suggests it could serve as an early marker, warranting further investigation.