Type 1 diabetes pressures the heart from the start

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Not only do parents of children with Type 1 diabetes need to watch their child’s blood sugar levels, they also need to pay attention to their kid’s blood pressure.

Children with Type 1 diabetes have six-fold greater odds of abnormal blood pressure than children without diabetes, according to a new study from BC Children’s Hospital and the University of British Columbia (UBC) that was recently published in Pediatric Diabetes.

Regardless of whether a child had Type 1 diabetes for five years or just three months, blood pressure abnormalities or hypertension, a condition in which blood pressure is persistently elevated, were common, researchers discovered.

“This study gives us the evidence we need to take an even closer look at how diabetes affects a child’s vascular health and pinpoint ways to intervene,”

said Dr. Angela Devlin, BC Children’s investigator in the Canucks for Kids Fund Childhood Diabetes Laboratories, associate professor in UBC’s department of pediatrics, a member of the BC Diabetes Research Network and the senior author of the study. “Further research could identify warning signs of future cardiovascular disease and enable clinicians to recommend lifestyle changes or other interventions to avoid the complications of diabetes such as hypertension and damage to the kidneys and heart.”

People with Type 1 diabetes have a 10-fold higher risk of cardiovascular disease compared to the general population, said Dr. Devlin. More than 2,000 children in B.C. live with Type 1 diabetes and determining when vascular damage first appears could help predict long-term cardiovascular health.

According to study co-author Dr. Dina Panagiotopoulos, a pediatric endocrinologist and an investigator with Canucks for Kids Fund Childhood Diabetes Laboratories at BC Children’s Hospital and a member of the BC Diabetes Research Network, the results were unexpected.

“We were surprised at how early the signs of vascular damage appeared in these children,” said Dr. Panagiotopoulos, who is also a clinical professor in pediatrics at UBC.

“This result suggests that the vascular health of children with Type 1 diabetes is not just a long-term consideration, but an immediate one.”

The study included 57 kids with Type 1 diabetes who are followed by the Endocrine and Diabetes Unit at BC Children’s who were between the ages of nine and 17, and 29 children without diabetes. The children were asked to wear a blood pressure monitor that took readings every 20 to 30 minutes over a 24-hour period.

Researchers found that children with Type 1 diabetes were six times more likely to have abnormal blood pressure readings than children without the disease, when accounting for factors such as age, sex and body-mass index. The study found that many of these children exhibited blood pressure abnormalities at night, which would have been missed at the clinic, and suggests more extensive blood pressure monitoring might be needed.

This is one of the first studies to monitor blood pressure in children diagnosed with Type 1 diabetes and compare rates to those of children without diabetes.

Dr. Kevin C. Harris, a pediatric cardiologist and investigator at BC Children’s, provided expertise on vascular assessments for this study and Dr. Janis Dionne, a pediatric nephrologist and investigator at BC Children’s, provided expertise on 24-hour blood pressure monitoring and data interpretation.

The Canucks for Kids Fund and an investigator grant from BC Children’s Hospital Research Institute supported the study.

Next, the researchers plan to investigate how vascular damage arises in children with Type 1 diabetes and whether it’s possible to pinpoint indicators of when intervention is necessary.

BCCHR Communications
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