Cardiovascular risk in children and adolescents with type 1 diabetes Mellitus

Autopsies of healthy children and adolescents have shown that the build up of atherosclerotic arterial wall lesions starts in childhood and that there is a close connection between the extent of the alterations and the atherogenic risk factors known in adults. The more cardiovascular risk factors there are, the faster the atherogenesis will progress. Data collection with the aid of the diabetes software to document prospective progress (DPV) in type I diabetic children and adolescents shows that the incidence of cardiovascular risk factors in juvenile diabetics is already very high and increases with age. Girls show worse diabetes control, have a higher BMI, higher LDL and lower HDL cholesterol levels, boys on the other hand have higher systolic blood pressure levels and slightly more of them smoke. In spite of the high incidence of cardiovascular risk factors the data show that the extent of therapy is very low. 45 % of the patients had dyslipidaemia, but only 0.4 % were being treated with drugs. 11 % of the patients had elevated systolic or diastolic blood pressure, but only 2.1 % were being treated for hypertension. In diabetic adolescents with poor diabetic control particular attention should be given to dyslipidaemia. In patients with good diabetic control attention should be paid to raised systolic blood pressure levels. The basic rule is therefore: cardiovascular risk factors should already be looked for in childhood and adolescence. Once detected they should be treated: think of the future now!.