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Cardiovascular autonomic dysfunction in diabetes mellitus

L Barkai¹, L Madácsy

¹II Department of Paediatrics, Postgraduate Medical Faculty, Imre Haynal University of Health Sciences, Miskolc, Hungary.

Archives of Disease in Childhood

|December 1, 1995

Summary

Cardiovascular autonomic dysfunction is common in children with type 1 diabetes. Maintaining optimal metabolic control is crucial to prevent or delay these complications.

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Area of Science:

Pediatric Endocrinology
Autonomic Neurology
Cardiology

Background:

Cardiovascular autonomic dysfunction (CAD) is a known complication of diabetes mellitus.
Early detection and management are essential to prevent severe cardiovascular events.

Purpose of the Study:

To evaluate the prevalence and characteristics of cardiovascular autonomic dysfunction in children and adolescents with type 1 diabetes.
To identify risk factors associated with CAD in this population.

Main Methods:

A case-control study involving 110 children and adolescents with type 1 diabetes and 130 non-diabetic controls.
Assessment of cardiovascular autonomic function using tests such as heart rate variation to deep breathing and postural changes.
Statistical analysis including logistic regression to identify predictors of CAD.

Main Results:

Diabetic children exhibited significantly higher resting heart rate, reduced heart rate variation with deep breathing, and a lower standing/lying heart rate ratio compared to controls.
42% of diabetic children had at least one abnormal autonomic test result.
Longer diabetes duration and poorer long-term metabolic control were independent predictors of CAD.

Conclusions:

Cardiovascular autonomic dysfunction is prevalent in children and adolescents with type 1 diabetes.
Effective metabolic control is vital for preventing or delaying the onset of CAD in pediatric diabetes.
Routine screening for autonomic dysfunction should be considered in diabetic children.

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