Macrovascular angiopathy in children and adolescents with type 1 diabetes

Abstract

Diabetes represents one of the most common diseases globally. Worryingly, the worldwide incidence of type 1 diabetes (T1D) is rising by 3% per year. Despite the rapid increase in diabetes incidence, recent advances in diabetes treatment have been successful in decreasing morbidity and mortality from diabetes-related retinopathy, nephropathy, and neuropathy. In contrast, there is clear evidence for the lack of improvement in mortality for cardiovascular diseases (CVDs). This emphasizes the importance of focusing childhood diabetes care strategies for the prevention of CVD in adulthood. Furthermore, although most work on diabetes and macrovascular disease relates to type 2 diabetes, it has been shown that the age-adjusted relative risk of CVD in T1D far exceeds that in type 2 diabetes. As T1D appears predominantly during childhood, those with T1D are at greater risk for coronary events early in life and require lifelong medical attention. Because of the important health effects of CVDs in children and adolescents with T1D, patients, family members, and care providers should understand the interaction of T1D and cardiovascular risk. In addition, optimal cardiac care for the patient with diabetes should focus on aggressive management of traditional cardiovascular risk factors to optimize those well-recognized as well as new specific risk factors which are becoming available. Therefore, a complete characterization of the molecular mechanisms involved in the development and progression of macrovascular angiopathy is needed. Furthermore, as vascular abnormalities begin as early as in childhood, potentially modifiable risk factors should be identified at an early stage of vascular disease development.

Serum levels of endothelial monocyte activating polypeptide-II in type 1 diabetes patients with microangyopathy and arterial hypertention.

“…Изменение концентрации циркулирующих эндоте-лиальных продуктов может указывать на эндотелиальную активацию и дисфункцию на доклинической стадии [15].…”

“…Многочисленные исследования указывают на то, что атеросклеротический процесс начинается уже в подростковом возрасте, а его про-грессирование определяется теми же факторами, что и у взрослых [7]. Проспективные исследования по-казали связь между традиционными факторами риска сердечно-сосудистой патологии у здоровых детей и ате-росклеротическим поражением каротидных сосудов во взрослой жизни [8].…”

Serum Adiponectin and hsCRP Levels and Non-Invasive Radiological Methods in the Early Diagnosis of Cardiovascular System Complications in Children and Adolescents with Type 1 Diabetes Mellitus

“…Studies in this issue are still ongoing (18,19). In our study, a number of markers of subclinical CVD and of cardiac (LV and RV) function were simultaneously examined in a population of asymptomatic children and adolescents with T1DM receiving a basal-bolus regimen.…”

Glycemic variability predicts inflammation in adolescents with type 1 diabetes

“…Cardiovascular disease is the major cause of death for patients with type 1 diabetes (T1D) [1] and there is clear evidence that cardiovascular disease has its origins in childhood and adolescence [2–5]. Inflammation and vascular endothelial injury are early events in nearly all forms of cardiovascular disease and several studies have shown that these biomarkers are also elevated in adolescents with type 1 diabetes prior to the clinical development of cardiovascular complications [6, 7].…”