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Related Experiment Videos

Microvascular abnormalities in pediatric diabetic patients.

Anthony T W Cheung1, Amber R Price, Patricia L Duong

  • 1Department of Medical Pathology, University of California, Davis School of Medicine, 95616, USA.

Microvascular Research
|April 24, 2002
PubMed
Summary

Pediatric type 1 diabetes patients exhibit microvascular abnormalities, similar to adults, detectable noninvasively. These abnormalities correlate with hemoglobin A1c, not disease duration, suggesting early pathogenesis.

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Area of Science:

  • Ophthalmology
  • Diabetology
  • Vascular Biology

Background:

  • Microvascular abnormalities are linked to organ damage in adult diabetics.
  • The presence and study of these abnormalities in pediatric diabetics were previously limited by technological and methodological constraints.

Purpose of the Study:

  • To investigate the presence of microvascular abnormalities in pediatric type 1 diabetes mellitus (T1DM) patients.
  • To adapt computer-assisted intravital microscopy (CAIM) for noninvasive in vivo assessment of conjunctival microcirculation in young patients.

Main Methods:

  • CAIM was utilized to quantify microvascular abnormalities in the bulbar conjunctiva of 12 pediatric T1DM patients (ages 6-16).
  • A severity index (SI) was developed by summing all observed microvascular abnormalities.

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  • SI in T1DM patients was compared to a control group and correlated with hemoglobin A1c and disease duration.

    • Main Results:

    • All pediatric T1DM patients displayed microvascular abnormalities in the conjunctiva.
    • The severity index (SI) was significantly higher in T1DM patients compared to controls (P < 0.0001).
    • SI correlated with hemoglobin A1c levels but not with the duration of diabetes.

    Conclusions:

    • Microvascular abnormalities are present in pediatric T1DM patients, even with short disease duration.
    • CAIM is a viable real-time technology for studying conjunctival microvascular changes in pediatric and adult vascular diseases.
    • Diabetic pathogenesis may begin before clinical diagnosis or overt symptoms in children.