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Interventions to Decrease Carotid-Intima Media Thickness in Children and Adolescents With Type 1 Diabetes: A
Adina Mihaela Epure1,2, Daniela Anker1, Stefano Di Bernardo3
1Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland.
Frontiers in Clinical Diabetes and Healthcare
|March 30, 2023
Summary
Pharmacological interventions may reduce carotid-intima media thickness (CIMT) in children with type 1 diabetes. However, evidence is limited, and further research is needed to confirm these effects.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Health
- Medical Interventions
Background:
- Hyperglycemia elevates cardiovascular risk, indicated by increased carotid-intima media thickness (CIMT) in youth with diabetes.
- Assessing interventions to mitigate CIMT in pediatric diabetes is crucial for long-term cardiovascular health.
Approach:
- Systematic review and meta-analysis of interventional studies on CIMT in children and adolescents with prediabetes or diabetes.
- Searched MEDLINE, EMBASE, CENTRAL, and trial registers up to September 2019.
- Included 6 studies (644 participants) focusing on type 1 diabetes; excluded prediabetes and type 2 diabetes.
Key Points:
- Metformin showed a pooled CIMT difference of -0.01 mm (95% CI: -0.04 to 0.01) vs. placebo.
- Quinapril showed a CIMT difference of -0.01 mm (95% CI: -0.03 to 0.01) vs. placebo.
- Physical exercise showed a mean CIMT change of -0.03 mm (95% CI: -0.14 to 0.08); results for CSII and atorvastatin were inconsistent.
Conclusions:
- Some pharmacological treatments may reduce CIMT in pediatric type 1 diabetes, but effects are uncertain.
- Limited number of RCTs, small sample sizes, and high risk of bias in non-RCTs restrict definitive conclusions.
- Larger, high-quality RCTs are necessary to establish the efficacy of interventions on CIMT in this population.
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