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Related Experiment Videos

Cardiac autonomic dysfunction in diabetic children.

M M Massin1, B Derkenne, M Tallsund

  • 1Division of Pediatric Cardiology, University of Liège, Belgium. martial.massin@chrcitadelle.be

Diabetes Care
|November 5, 1999
PubMed
Summary

Heart rate variability (HRV) analysis can detect early cardiac autonomic neuropathy in children with type 1 diabetes, especially around puberty. Screening is recommended at puberty

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Area of Science:

  • Pediatric Endocrinology
  • Cardiology
  • Diabetology

Background:

  • Type 1 diabetes can lead to cardiac autonomic neuropathy, affecting heart rate variability (HRV) in adults.
  • Subclinical autonomic dysfunction may be present in diabetic children, impacting cardiovascular health.
  • Early detection of neuropathy is crucial for managing long-term complications in pediatric diabetes.

Purpose of the Study:

  • To investigate the utility of HRV analysis in detecting subclinical cardiac autonomic neuropathy in children with type 1 diabetes.
  • To determine if HRV indices correlate with established risk factors for diabetic complications in pediatric populations.

Main Methods:

  • Prospective study involving 73 children and adolescents (3-18 years) with type 1 diabetes.
  • Analysis of 24-hour Holter recordings to assess time and frequency domain HRV indices.

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  • Comparison of HRV measures with normal ranges and correlation with metabolic control, illness duration, and microalbuminuria.

    • Main Results:

    • HRV indices were significantly reduced in diabetic children aged 11 years and older.
    • HRV abnormalities correlated with long-term metabolic control (4-year mean GHb) in older children.
    • Illness duration and microalbuminuria independently predicted HRV abnormalities, while recent metabolic control did not.

    Conclusions:

    • Early puberty is a critical period for developing diabetic cardiac autonomic dysfunction.
    • HRV analysis is a valuable tool for screening type 1 diabetic patients for autonomic neuropathy starting at puberty.
    • Screening should be implemented regardless of illness duration, microalbuminuria, or current metabolic control levels.