ESPE Abstracts

Background: Arterial hypertension (AH) in young patients with Type 1 Diabetes (T1D) occurs more often, and at younger age than in general population. A reduction of nighttime dip value is considered as an early marker of AH risk.

The aim of this study: was to identify the association between AH, and abnormal nighttime dip and diabetes-related factors: duration time and glycemic control

Methods: In 357 patients with T1D (female 171/male 186) at the mean age 16.2 years standard 24-h Ambulatory Blood Pressure Monitoring (ABPM) was performed using an ABPM (Spacelabs 90217, USA). Normal nighttime dip was defined as a ≥10% decline in BP. Data were analyzed according to T1D duration (> 5 years - long duration, and < 5 years - short duration of disease), and HbA1c value at the moment of examination, and the mean value from the preceding year (>6.5% - insufficient control and <6.5 - good control).

Results: The mean duration time of T1D was 7 years (range 1-16.5). Mean HbA1c at the moment of examination was 7.6% (rage 5.26-14.%), the same as within the year preceding the examination. Arterial hypertension based on ABPM criteria was confirmed in 36 (10%) patients (19 girls, 17 boys), but in the group with insufficient control it was 34 (94%). Patients with longer T1D duration time presented with significantly higher mean diastolic BP (24h DBP) (68.9 vs. 67.4 mmHg, P = 0.04), and systolic load (15 vs. 17.5%, P = 0.04). Decreased nighttime dip (< 10%) was present in 148 (41%); 120 (62 girls, 58 boys) of them presented with insufficient glycemic control, 103 (55 girls, 48 boys) had long diabetes duration time.

Conclusion: Longer T1D duration and poorer metabolic control might be associated with a risk of an abnormal nighttime dip and AH. The duration time cannot be modified, but improve of metabolic control seems to be an important factor in the reduction of the risk of AH and its complications.