Subclinical Diastolic Indices in Children with Type 1 Diabetes: A Cross-Sectional Comparative Study from Northern...

Type 1 diabetes mellitus (T₁DM) is common and can cause cardiac complications. Subclinical myocardial involvement, particularly impaired diastolic function, is a concern in pediatric patients with T₁DM.

This study aimed to assess cardiac function, with a particular focus on diastolic indices, in children with T₁DM.

In this cross-sectional comparative study, children aged 6 - 12 years were divided into two groups: a case group with T₁DM and a control group of healthy children. Participants were recruited in 2023 from the Endocrinology Clinic at Amirkola Children's Hospital, Babol, Iran. All children underwent clinical evaluation, pubertal status assessment using the Marshall-Tanner criteria, electrocardiography, and echocardiography.

A total of 150 children were included, comprising 50 children with T₁DM and 100 controls. Overall, 52% of the participants were boys, and the mean age was 9.28 ± 1.85 years. Late diastolic tissue velocity (A') was significantly higher in the T₁DM group (P = 0.02), suggesting subclinical diastolic impairment. However, most other cardiac parameters, including all systolic indices, ejection fraction, fractional shortening, and electrocardiographic findings, were comparable between the groups (all P > 0.4). The T₁DM group also had higher mean weight, height, body mass index, and body mass index percentiles (all P < 0.05).

Children with T₁DM exhibited subtle diastolic dysfunction, reflected by elevated A', whereas systolic function and other cardiac parameters were comparable with those in controls. Given the cross-sectional design, limited sample size, and potential confounding by body mass index and selection bias, these findings should be interpreted cautiously. The standardized single-center methodology supports internal validity; however, multicenter longitudinal studies with larger, z-score-adjusted samples are needed to confirm these results and clarify their clinical implications.