Adolescents and young adults with type 1 diabetes display a high prevalence of endothelial dysfunction

AimLittle is known about endothelial function in adolescents with type 1 diabetes, and we evaluated endothelial dysfunction, using reactive hyperaemia peripheral arterial tonometry (RH-PAT). MethodsThis prospective, observational, 1-year study focused on 73 adolescents with type 1 diabetes, using multiple daily injections or continuous subcutaneous insulin infusion. The subjects were assessed using RH-PAT, body mass index, blood pressure, fasting lipid profile, glycated haemoglobin, insulin requirements and hours of physical exercise per week. ResultsEndothelial dysfunction was observed in 56 patients (76.7%), with lower mean RH-PAT scores (1.260.22 versus 2.24 +/- 0.48, p<0.0001) and higher glycated haemoglobin values at baseline (8.27 +/- 1.24% versus 7.37 +/- 0.54%, p=0.006) and as a mean of the whole period since diagnosis (8.25 +/- 1.22% versus 7.72 +/- 0.82%, p=0.034). A higher percentage of patients with endothelial dysfunction showed abnormal cardiac autonomic tests (p=0.02) and were more sedentary, exercising <4 hours a week, than patients with normal endothelial function. After follow-up in 64/73 patients, we observed endothelial dysfunction in 81.8% of patients, despite a modest improvement in glycated haemoglobin. ConclusionAdolescents with type 1 diabetes displayed evidence of endothelial dysfunction. Good metabolic control (glycated haemoglobin 7.5%, 58mmol/mol) and regular physical activity of at least 4h a week might be protective.