Left ventricular diastolic dysfunction in adolescents with type 1 diabetes reflects the long- but not short-term metabolic control.

OBJECTIVE: The aim of this study was to compare the LV morphology and function in adolescents with DM1 and their healthy peers. SUBJECTS AND METHODS: In 59 DM1 patients (30 girls, 29 boys,aged 14-17 years), and in control group (15 girls, 15 boys) LV was assessed by M-mode, 2D and Doppler echocardiography. The metabolic control was assessed in the long- (mean HbAlc value for the entire treatment period-HbA1c1), medium- (mean HbA1c for the past two pre-study years-HbA1c2), and short-term (HbA1c on the day of the study-HbA1c3).
RESULTS: Diabetic patients presented an increase of IRT (0.062 vs. 0.056 s, p < 0.05 in boys, and 0.062 vs. 0.056 s, p < 0.05 in girls), A wave (56.1 vs. 53.95 cm/s in boys, and 60.3 vs. 58 cm/s in girls), and deceleration time values (0.16 vs. 0.15 s in boys, and 0.17 vs. 0.15 s in girls), decrease of E wave (97.35 vs. 104.9 cm/s in boys, and 99.67 vs. 101.8 cm/s in girls), as well as the E/A ratio (1.79 vs. 2.0 in boys, and 1.7 vs. 1.78 in girls). The systolic function was normal. In girls there was a correlation between IRT and HbA1c1 and HbA1c2 (r = 0.42, r = 0.46, p < 0.05); between the A wave and HbA1c2 (r = 0.46, p < 0.05); between LV posterior wall systolic dimension and HbA1c1, HbA1c2 (r = 0.45, r = 0.41, p < 0.05), and in boys between the A wave and HbA1c1 and HbA1c2 (r = 0.48, p < 0.01; r = 0.37, p < 0.05).
CONCLUSIONS: Pubertal patients with DM1 demonstrate discrete impairment of the diastolic function beside normal systolic function of the LV. Further investigations are needed to assess the value of this observation. It seems that LV diastolic dysfunction in girls depends on the degree of insulin resistance and DM1 duration, and similarly as in boys, on the long-term metabolic control.