Evaluation of Cardiac Autonomic Dysfunctions in Children with Type 1 Diabetes Mellitus

Abstract

Abstract Background:Type 1 diabetes mellitus (T1DM) is one of the most common endocrine and metabolic diseases in children. Cardiovascular autonomic neuropathy (CAN) is an important and overlooked complication of diabetes, which almost doubles the mortality. Therefore early recognition and treatment will prevent the development of cardiovascular events. Aim of our study is to determine the necessary parameters to recognize cardiovascular dysfunctions that may develop due to CAN in the early period. Methods:In our study, 30 healthy children and 30 T1DM patients with poor glycemic control were evaluated. Echocardiographic data, heart rate variability (HRV) with 24-hour Holter electrocardiography, exercise capacities, and tilt table test for baroreceptor susceptibility were evaluated. Results: In our study, 30 patients with poor glycemic control were evaluated, their mean diabetes duration was 8±3.66(1-16) years. CAN that may develop in early childhood were evaluated in the patient group. It is observed that there was a decrease in HRV, this situation is accompanied by ventricular dysfunction and postural hypotension. Conclusion:CAN is one of the most common complications of T1DM and is associated with patient's age and poor glycemic control. Decreased baroreceptor susceptibility with autonomic dysfunction is associated with decreased ventricular diastolic functions, respiratory functions, and exercise capacity. In our study, we showed that cardiac autonomic dysfunction may develop in early childhood in T1DM patients with poor glycemic control. It may be valuable to evaluate HRV and tilt table tests in the early detection of CAN in pediatric groups.