Evaluation of left ventricular function in children and adolescents with type 1 diabetes

To assess the effect of type I diabetes mellitus on cardiac systolic and diastolic functions in children and adolescent patients.

The case-control study was conducted from January 1 to December 31, 2017, at Child's Central Teaching Hospital, Baghdad, Iraq, and comprised patients with type 1 diabetes and healthy controls aged 5-18 years for 3 years or more, Clinical evaluation, laboratory investigations, conventional echocardiography and Doppler assessment were done for each individual. Data was analysed using SPSS 25.

Of the 96 subjects, 48(50%) were cases; 19(39.6%) males and 29(60.4%) females. The remaining 48(50%) were the controls; 22(45.8%) males and 26(54.2%) females. The mean age and gender distribution between the groups was not significantly different (p>0.05). Among the cases, 37(77.1%) had glycated haemoglobin ≥7.5%, and 28(58.3%) had diabetes for 7 years or more. The cases had significantly longer isovolumic relaxation time than the controls (p=0.002). The cases also had significantly lower early diastolic filling velocity (p=0.022) and early diastolic filling velocity/late diastolic filling velocity ratio (p=0.047) than the controls. Patients with uncontrolled diabetes had significant changes in left atrial and ventricular diameters, left ventricular mass and mass index, and in early diastolic filling velocity compared to those with controlled diabetes (p<0.05). Also, patients with duration of diabetes ≥7 years had higher myocardial performance index and longer isovolumic contraction time than those with shorter duration (p<0.05).

Subclinical alterations in myocardial function induced by type 1 diabetes may start in asymptomatic individuals, and these changes are accelerated with poor glycaemic control and longer duration of diabetes.