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Impaired skin microcirculation in paediatric patients with type 1 diabetes mellitus

Mirjam Heimhalt-El Hamriti1, Corinna Schreiver, Anja Noerenberg

  • 1Department of Paediatrics, University Hospital Rostock, Germany. dagmar-christiane.fischer@med.uni-rostock.de

Cardiovascular Diabetology
|August 14, 2013
PubMed

Insights

Pediatric type 1 diabetes is linked to early endothelial dysfunction, affecting skin microcirculation. This study defines normal function and identifies impaired responses in 25% of young patients.

Area of Science:

  • Pediatric Endocrinology
  • Cardiovascular Physiology
  • Microcirculation Research

Background:

  • Endothelial dysfunction is an early complication of type 1 diabetes.
  • Assessing microvascular function in children is crucial for early detection and management.
  • Laser Doppler Fluximetry (LDF) is a valuable tool for evaluating skin microcirculation.

Purpose of the Study:

  • To establish normative data for endothelial function in healthy children and adolescents using LDF.
  • To investigate skin microcirculation and endothelial function in pediatric patients with type 1 diabetes mellitus.
  • To identify the prevalence of microvascular endothelial dysfunction in this pediatric cohort.

Main Methods:

  • Utilized Laser Doppler Fluximetry (LDF) in 102 healthy children and 68 pediatric patients with type 1 diabetes.
  • Applied three stimulation protocols: localized thermal hyperemia, iontophoresis of pilocarpine hydrochloride (PCH), and sodium nitroprusside (SNP).
  • Quantified skin blood flow response, including maximum increase and area under the curve (AUC), and calculated axon reflex-mediated vasodilation (ARR).

Main Results:

  • Established normative LDF parameters (AUCheat, AUCPCH, AUCSNP, ARR) in healthy children, independent of age and sex.
  • Diabetic pediatric patients exhibited significantly reduced vasodilatory responses to thermal hyperemia and SNP compared to controls.
  • A higher frequency of impaired vasodilation and pathological vascular responses was observed in diabetic patients, even with short disease duration.

Conclusions:

  • Microvascular endothelial dysfunction is prevalent in approximately 25% of pediatric type 1 diabetes patients with at least one year of disease.
  • Early detection of endothelial dysfunction in pediatric diabetes is possible through microcirculation assessment.
  • Further research is warranted to determine the predictive value of endothelial dysfunction for long-term cardiovascular complications.
Abstract

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