scholarly journals FEATURES OF THE DAILY PROFILE OF ARTERIAL PRESSURE AND THE POSSIBILITY OF DOCLINE DIAGNOSTICS OF ARTERIAL HYPERTENSION IN CHILDREN WITH TYPE 1 DIABETES

2020 ◽  
Vol 75 (3) ◽  
pp. 75-78
Author(s):  
N.V. Malyuzhinskaya ◽  
◽  
K.V. Stepanenko ◽  
O.V. Polyakova ◽  
G.V. Klitochenko ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mathematical Model ◽  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
Arterial Hypertension ◽  
Laser Doppler Flowmeter ◽  
Microcirculatory Disorders ◽  
Hypertension In Children ◽  
Doppler Flowmeter

Diabetic nephropathy takes a leading place among diseases requiring replacement therapy for renal failure, and is also a leading cause of disability and mortality among patients with type 1 diabetes. The development of arterial hypertension is one of the markers of the formation of diabetic nephropathy. We performed a prospective cohort study. A comprehensive clinical and instrumental examination of 78 children with type 1 diabetes was carried out. The features of changes in the daily profile of blood pressure and microcirculatory disorders in children before the formation of diabetic nephropathy were revealed. A mathematical model is developed for predicting the development of arterial hypertension by determining microcirculation parameters using a laser Doppler flowmeter. Early diagnosis will allow timely prescribing of pathogenetic treatment, improving the prognosis of this category of patients.

scholarly journals Early Diabetic Nephropathy and Retinopathy in Patients with Type 1 Diabetes Mellitus Attending Sudan Childhood Diabetes Centre

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Hana Ahmed ◽  
Tayseer Elshaikh ◽  
Mohamed Abdullah
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Diabetic Retinopathy ◽  
Risk Factor ◽  
Diabetic Nephropathy ◽  
Type 1 Diabetes Mellitus ◽  
Ethnic Group ◽  
Childhood Diabetes

Objective. Data on microvascular complications in children and adolescents with type 1 diabetes mellitus (T1DM) in Sudan are scarce. This study was aimed at determining the prevalence of diabetic nephropathy (DN) and retinopathy (DR) and their relationship to certain risk factors in children with T1DM attending the Sudan Childhood Diabetes Centre. Design and Methods. A clinic-based cross-sectional study of 100 patients with T1DM aged 10-18 years. Patients with disease duration exceeding 5 years if the onset of diabetes was prepubertal and 2 years if it was postpubertal were included. Relevant sociodemographic, clinical, and biochemical information was obtained. Blood pressure was measured. The patients were screened for DN and DR using urinary microalbumin estimation and fundus photography, respectively. Results. The frequency of microalbuminuria and diabetic retinopathy was 36% and 33%, respectively. Eleven percent had both retinopathy and microalbuminuria. Seven percent of the patients were found to be hypertensive. Patients with diabetic retinopathy had significantly higher HbA1c levels ( p = 0.009 ) and longer diabetes duration ( p = 0.02 ) than patients without retinopathy. Logistic regression showed that high HbA1c (odds ratio (OR) 0.83, confidence interval (CI) 0.68-1.00, p = 0.04 ), but not age, duration, ethnic group, BMI, blood pressure, and presence of nephropathy, was an independent risk factor for retinopathy. Likewise, high blood pressure (OR 6.89, CI 1.17-40.52, p = 0.03 ), but not age, duration, ethnic group, BMI, HbA1c, and presence of retinopathy, was a predictor for nephropathy. Conclusion. High prevalence of incipient DN and early stages of DR were observed in this study. Longer diabetes duration and higher HbA1c were associated with the presence of diabetic retinopathy. High blood pressure was a risk factor for DN. So regular screening for these complications and optimization of glycemic control are needed.

scholarly journals Daily blood pressure variations in patients with type 1 diabetes mellitus and nephropathy

2003 ◽  
Vol 49 (5) ◽  
pp. 5-10
Author(s):  
I. A. Bondar ◽  
V. V. Klimontov ◽  
Ye. A. Korolyova ◽  
L. I. Zheltova
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Arterial Hypertension ◽  
Type 1 Diabetes Mellitus ◽  
Autonomic Dysfunction ◽  
Blood Pressure Monitoring ◽  
Inpatient Setting ◽  
Systemic Hemodynamic

То study a relationship between systemic hemodynamic parameters, albuminuria, and autonomic dysfunction in patients with type 1 diabetes mellitus (DM-1) without obvious nephropathy, the authors examined 55 patients in the inpatient setting. Twenty-nine patients had a normal urinary albumin excretion (CAE), 26 patients had microalbuminuria. 24-hour blood pressure monitoring (24-h BPM) was occillometrically made. The average daily, average diurnal and nocturnal values of systolic and diastolic blood pressure (BP) were significantly higher in DM-1 patients with microalbuniuria than in those with normal UAE. Routine autonomic cardiovascular tests showed that the incidence and severity of autonomic neuropathy were also higher in patients with microalbuminuria. Arterial hypertension (AH) diagnosed in compliance with the 24-h BPM criteria was detected. in 17.2%) of the DM-1 patients with normal UAE and in 42.3%) of the patients with microalbuminuria. According to the data of 24-h BPM, the incidence of arterial hypertension was 1.7 times as high as that evidenced by single BP measurements. The specific feature of circadian hemodynamic variations in patients with DM-1 was a low nocturnal BP decrease. 37.9%) of the patients with normoalbuminuria and 61.5%) of the patients with microalbuminuria had no normal (>10%)) nocturnal BP lowering. Stepwise regression analysis has ascertained that in patients with DM-1 without obvious nephropathy, systemic hemodynamic disorders are associated with albuminuria, autonomic dysfunction, and glycemic monitoring quality.

Nocturnal blood pressure cut off points related to the development of microvascular complications and arterial hypertension in patients with type 1 diabetes

2015 ◽  
Author(s):  
Maria Belen Ojeda-Schuldt ◽  
Isabel Mateo-Gavira ◽  
Francisco Javier Vilchez-Lopez ◽  
Ana Montero-Galvan ◽  
Jose Ortejo-Rojo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Arterial Hypertension ◽  
Microvascular Complications ◽  
Nocturnal Blood Pressure

scholarly journals Evidence of Early Diabetic Nephropathy in Pediatric Type 1 Diabetes

2021 ◽  
Vol 12 ◽  
Author(s):  
Leena Mamilly ◽  
Lucy D. Mastrandrea ◽  
Claudia Mosquera Vasquez ◽  
Brett Klamer ◽  
Mahmoud Kallash ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
Blood Glucose ◽  
Diabetic Patients ◽  
Urinary Ngal ◽  
High Blood Glucose ◽  
Urinary Markers

BackgroundDiabetic nephropathy (DN) is one of the most common microvascular complications in type 1 diabetes Mellitus (T1D). Urinary markers of renal damage or oxidative stress may signal early stages of DN. The association of these markers with blood pressure (BP) patterns and glycemic variability (GV) in children is yet to be explored.MethodsSubjects between the ages of 10 and 21 years with T1D were enrolled. Continuous glucose monitoring (CGM) and ambulatory blood pressure monitoring (ABPM) were performed on each subject. Urine samples were collected and analyzed for albumin, creatinine, neutrophil gelatinase-associated lipocalin (NGAL) and pentosidine.ResultsThe study included 21 subjects (62% female) with median age of 16.8 (IQR: 14.5, 18.9). Median HbA1C was 8.4 (IQR: 7.5, 9.3). While microalbuminuria was negative in all but one case (4.8%), urinary NGAL/Cr and pentosidine/Cr ratios were significantly elevated (P<0.001) in diabetic patients despite having normal microalbuminuria, and they correlated significantly with level of microalbumin/Cr (r=0.56 [CI: 0.17, 0.8] and r=0.79 [CI: 0.54, 0.91], respectively). Using ABPM, none had hypertension, however, poor nocturnal systolic BP dipping was found in 48% of cases (95% CI: 28-68%). Urinary NGAL/Cr negatively correlated with nocturnal SBP dipping (r=-0.47, CI: -0.76, -0.03). Urine NGAL/Cr also showed a significant negative correlation with HbA1c measurements, mean blood glucose, and high blood glucose index (r=-0.51 [CI: -0.78, -0.09], r=-0.45 [CI: -0.74, -0.03], and r=-0.51 [CI: -0.77, -0.1], respectively). Median urinary NGAL/Cr and pentosidine/Cr ratios were higher in the high GV group but were not significantly different.DiscussionThis pilot study explores the role of ABPM and urinary markers of tubular health and oxidative stress in early detection of diabetic nephropathy. GV may play a role in the process of this diabetic complication.

A Case of Diabetic Nephropathy in a Child with Type 1 Diabetes

2008 ◽  
Vol 12 (2) ◽  
pp. 250 ◽  
Author(s):  
Hwan-Hee Jung ◽  
Sung-Sin Park ◽  
Sung-Do Kim ◽  
Byoung-Soo Cho
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Nephropathy

Clinic blood pressure shows low sensitivity to detect alterations in ambulatory blood pressure monitoring in patients with type 1 diabetes

2014 ◽  
Author(s):  
Francisco Javier Vilchez-Lopez ◽  
Isabel Mateo-Gavira ◽  
Florentino Carral-San Laureano ◽  
Maria Victoria Garcia-Palacios ◽  
Jose Ortego-Rojo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Ambulatory Blood Pressure Monitoring ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Clinic Blood Pressure ◽  
Pressure Monitoring ◽  
Low Sensitivity
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