Related Experiment Videos
Vascular reactivity and platelet aggregability during the first five years of insulin-dependent diabetes in children
1Department of Paediatrics, Uppsala University Children's Hospital, Sweden.
Insights
Children with type 1 diabetes mellitus show persistent impaired skin microvascular vasodilation over five years. While collagen-induced platelet aggregation increased, adenosine diphosphate (ADP)-induced aggregation decreased, with girls exhibiting greater vasodilator impairment.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Physiology
- Diabetes Mellitus Research
Background:
- Type 1 diabetes mellitus (IDDM) diagnosis in children can impact microvascular function and platelet activity.
- Longitudinal studies are crucial to understand the progression of vascular complications in pediatric diabetes.
Purpose of the Study:
- To prospectively evaluate skin microvascular reactivity and platelet aggregation in children with newly diagnosed IDDM over a 5-year period.
- To identify potential sex differences in vascular responses among pediatric diabetic patients.
Main Methods:
- Prospective, longitudinal study involving children with newly diagnosed IDDM.
- Assessment of skin microvascular vasodilation using transcutaneous oximetry during ischemic conditions.
- Measurement of platelet aggregation in response to collagen and adenosine diphosphate (ADP).
- Comparison with healthy control groups.
Main Results:
- Impaired skin microvascular vasodilation persisted at 60 months post-diagnosis, remaining significantly lower than in controls.
- Diabetic girls showed greater impairment in vasodilator capacity compared to diabetic boys, particularly during and after puberty.
- Platelet aggregation in response to collagen increased significantly from admission to 60 months but did not differ from controls.
- Platelet aggregation in response to ADP decreased over the 60-month period compared to admission levels.
Conclusions:
- Persistent impairment of skin microvascular vasodilation is a significant finding in children with type 1 diabetes over five years.
- The evolving pattern of platelet aggregation, with increased collagen response and decreased ADP response, warrants further investigation.
- The implications of these vascular changes for the development of diabetic angiopathy in children require long-term evaluation.
Abstract:
Skin microvascular reactivity and platelet aggregation in response to collagen and adenosine diphosphate (ADP) was studied prospectively in a population-based cohort of children with newly acquired type 1 diabetes mellitus (IDDM), who have now been followed up longitudinally for 5 years. The skin microvascular vasodilation in response to ischaemia was recorded by means of transcutaneous oximetry at 37 degrees C and compared with that in a control group of 58 healthy children. Platelet aggregation was compared with 42 healthy control children. Sixty months after diagnosis, the same degree of impairment of vasodilatory capacity was noted as previously recorded at 24 months and on admission, on all these occasions being significantly lower than the control value and the results from the 12-month follow-up. A sex difference was noted, diabetic girls both during and after puberty exhibiting a greater impairment of vasodilator capacity as compared with diabetic boys. The same degree of platelet aggregation in response to collagen was noted 60 months after diagnosis as had been recorded previously at 24 and 12 months, all significantly increased as compared with the results from admission, but not different from those in controls. By contrast, the aggregation in response to ADP was now lower than that observed on admission. No statistically significant gender difference was noted. The implication of the impaired skin microvascular vasodilation and of the changing pattern of platelet aggregation for later diabetic angiopathy needs to be evaluated in the coming decade.