Subclinical left ventricular systolic and diastolic dysfunction in type 1 diabetic children and adolescents with good metabolic control

2017 ◽  
Vol 35 (2) ◽  
pp. 227-233 ◽  
Author(s):  
Tamer Yoldaş ◽  
Utku Arman Örün ◽  
Elif Sagsak ◽  
Zehra Aycan ◽  
Özkan Kaya ◽  
...  
Author(s):  
Hesham Ali Elbahgy ◽  
Mohamed Khalfallah ◽  
Randa Mohamed Abdel-Meged ◽  
Mai M. Abd Elmoneim Salama

Background: Diabetic patients with normal left ventricular ejection fraction (LVEF)are frequently associated with diastolic dysfunction. However, LVEF is known not to be a sensitive marker for the detection of subclinical LV systolic dysfunction. This study aimed to assess left ventricular systolic and diastolic function in asymptomatic type 1 diabetic patients by conventional, tissue Doppler and two-dimensional speckle tracking echocardiography to assess subclinical left ventricular systolic and diastolic dysfunction. Methods: Case-control study was conducted at 150 patients aged 15-35 y were subdivided into three equal groups: Group A: with type 1 diabetes mellitus (T1DM) with good metabolic control (Hb A1C <7.0), Group B: T1DM with poor metabolic control (Hb A1C>7.0), and Group C: Control group: included 50 normal healthy subjects. Results: Tissue Doppler, diastolic function and strain parameters, AP4C LS, AP2C LS, AP3C LS, and GLS were significantly impaired among the three groups. AP4C LS, AP2C LS, AP3C LS, and GLS were significantly lower in group B than group A and group C and was significantly lower in group A than group C, A velocity was significantly impaired among the three groups. A velocity was significantly higher in group B than group A and group C and was insignificantly impaired in group A than group C. Conclusion: Conventional echocardiography parameters were insignificantly different between the study groups. 2D speckle tracking and tissue Doppler echocardiography showed that subclinical left ventricular systolic function may be affected even before affection of diastolic function. Longer duration and poor glycemic control of diabetes significantly affect GLS.


2021 ◽  
Author(s):  
María Teresa Pastor-Fajardo ◽  
María Teresa Fajardo-Giménez ◽  
Vicente Bosch-Giménez ◽  
José Pastor-Rosado

Abstract Background: In recent decades, a global increase in the prevalence of childhood overweight and obesity has been observed in children and adolescents with type 1 diabetes.Methods: This retrospective, cross-sectional, population study examined three groups (1986, 2007, and 2018) of children and adolescents aged <16 years diagnosed with type 1 diabetes. Overweight and obesity were defined according to the World Health Organization recommendations.Results: The prevalence of overweight and obesity in diabetic children and adolescents was 30.2% (95% CI: 23.1-38.3). There was a significant increase from 1986 to 2007 (11.9% to 41.7%, p=0.002) and from 1986 to 2018 (11.9% to 34.8%, p=0.012), but no significant differences were found from 2007 to 2018 (41.7% to 34.8%, p=0.492). The age at diagnosis was lower in the group with excess body mass (p=0.037). No significant differences were observed in age (p=0.690), duration of diabetes (p=0.163), distribution according to sex (p=0.452), metabolic control (HbA1c, p=0.909), or insulin units kg/day (p=0.566), in diabetic patients with overweight or obesity. From 2007 to 2018, the use of insulin analogs (p=0.009) and a higher number of insulin doses (p=0.007) increased significantly, with no increase in the prevalence of overweight and obesity.Conclusions: The evolution of the prevalence of overweight and obesity in diabetic children and adolescents during the study period is a reflection of the epidemic of childhood obesity in a global obesogenic environment.


2016 ◽  
Vol 4 (2) ◽  
pp. 81-87 ◽  
Author(s):  
Amir Hodzic ◽  
Virginie Ribault ◽  
Pascale Maragnes ◽  
Paul Milliez ◽  
Eric Saloux ◽  
...  

Abstract Background and Objectives Type 1 diabetes is a major cardiovascular risk factor associated with an excess of mortality in young adults due to premature cardiovascular events, which includes heart failure. The relation between type 1 diabetes and cardiac structure and function in children was poorly documented. Our study investigates (1) whether type 1 diabetic children have echocardiographic signs of subclinical cardiac dysfunction assessed by tissue Doppler strain and (2) whether state of metabolic control and diabetes duration have any influence on the cardiac event. Methods Standard echocardiography and tissue Doppler imaging were prospectively performed in type 1 diabetic children. Left ventricular dimensions, standard indices of systolic and diastolic function, and septal longitudinal strain were investigated. Results Thirty consecutive asymptomatic diabetic children (age: 12.4 [5–17] years; males: 53%) were compared to 30 age and sex-matched healthy control subjects. Left ventricular mass index and diastolic septal thickness were significantly increased in diabetic children. There was no difference between two groups as regards the left ventricular ejection fraction and conventional mitral Doppler parameters (E, A, Ea). The global longitudinal systolic strain and strain rate were found to be decreased in children with diabetes. The global longitudinal early diastolic strain rate (Esr) was negatively correlated with metabolic control. Longitudinal strain was not correlated with diabetes duration. Conclusion Children with Type 1 diabetes had subclinical alterations in left ventricular size and longitudinal myocardial deformation.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yan Wang ◽  
Lin Xing ◽  
Hui Yu ◽  
LiJuan Zhao

Abstract Background Dental caries and type 1 diabetes are responsible for a large burden of global disease; however, the exact prevalence of dental caries among children and adolescents with type 1 diabetes remains controversial, and no quantitative meta-analysis exists. Thus, we performed a meta-analysis to evaluate the prevalence of dental caries among children and adolescents with type 1 diabetes. Methods We performed a systematic search strategy using PubMed, EMBASE and China National Knowledge Infrastructure for relevant studies investigating the prevalence of dental caries in children and adolescents with type 1 diabetes from July 1971 until December 2018. The pooled prevalence with 95% confidence intervals (95%CIs) and subgroup analyses were calculated using a random effects model. Results After screening 358 non-duplicated articles, a total of 10 articles involving 538 individuals were included. The overall prevalence of dental caries among children and adolescents with type 1 diabetes was 67% (95% CI: 0.56–0.77%; I2 = 83%). The prevalence was highest in South America (84%) and lowest in diabetic patients with good metabolic control (47%). Conclusions The prevalence of dental caries was high among children and adolescents with type 1 diabetes. Screening and preventive treatment should be included in dental clinical routines for diabetic children and adolescents, especially in those with poor metabolic control.


2013 ◽  
Vol 52 (36) ◽  
pp. 13020-13033 ◽  
Author(s):  
Naviyn Prabhu Balakrishnan ◽  
Lakshminarayanan Samavedham ◽  
Gade Pandu Rangaiah

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