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Cardiovascular Function/Dysfunction in Adolescents with Type 1 Diabetes

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Abstract

Type 1 diabetes mellitus (T1D) is associated with an increased risk of cardiovascular disease (CVD) that begins in childhood. Youth with T1D develop concerning functional cardiac and vascular defects and evidence of early atherosclerosis, despite modern advancements in risk reduction and glycemic management. Such early defects predict poor long-term outcomes. Women with T1D also have higher CVD risk than expected for unexplained reasons. Insulin resistance (IR) is recently recognized as a prominent factor in T1D youth and adults, but with an atypical clinical phenotype. This IR may contribute to early cardiac and vascular dysfunction and long-term CVD in T1D. A better understanding of potential contributors to cardiovascular dysfunction in T1D youth such as IR and its unique phenotype in T1D, subtle lipid abnormalities, and gender differences is now required to address the current knowledge gaps and to prevent cardiovascular morbidity and mortality in T1D.

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Abbreviations

CACTI:

Coronary Artery Calcification in Type 1 Diabetes

DCCT:

Diabetes Control and Complications Trial

EDC:

Epidemiology of Diabetes Complications

EDIC:

Epidemiology of Diabetes Interventions and Complications

NHANES III:

Third National Health and Nutrition Examination Survey

SEARCH:

Search for Diabetes in Youth

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Acknowledgments

We would like to acknowledge funding from the following sources: KJN (K23 020038Award, DK61242, Juvenile Diabetes Research Foundation [PI Nadeau]); KJN and JEBR (UL1 RR025780, University of Colorado Center for Women’s Health Research), JEBR (VA Merit Review, ADA research Award, DK57516, HL14985), NIH/CRR Colorado CTSI Grant Number UL1 RR025780. We would also like to acknowledge Amy West for her assistance with literature searches used to prepare this manuscript.

Disclosure

Conflicts of interest: K.J. Nadeau: none; J.E.B. Reusch: has received ITT grant funding from Amylin, GlaxoSmithKline, and Bristol-Myers Squibb.

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Authors and Affiliations

  1. Pediatric Endocrinology, University of Colorado/The Children’s Hospital, 13123 East 16th Avenue, B265, Aurora, CO, 80045, USA

    Kristen J. Nadeau

  2. Endocrinology, Diabetes and Metabolism, Denver VAMC and University of Colorado, Denver, ENDO 111-H/Rm9c120b, 1055 Clermont Street, Denver, CO, 80220, USA

    Jane E. B. Reusch

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Correspondence to Kristen J. Nadeau.

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Nadeau, K.J., Reusch, J.E.B. Cardiovascular Function/Dysfunction in Adolescents with Type 1 Diabetes. Curr Diab Rep 11, 185–192 (2011). https://doi.org/10.1007/s11892-011-0180-4

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