title: Poor glycemic control is associated with increased diastolic blood pressure and heart rate in children with Type 1 diabetes.
abstract: Although higher levels of hemoglobin A1c (HbA1c) and blood pressure precede the development of nephropathy in Type 1 diabetes (T1DM), the relationship between glycemic control and cardiovascular factors early in the course of diabetes is not clear. We conducted a retrospective study from clinic data for a 1-year period in 148 children with T1DM aged 12.5+/-4.4 years who had average diabetes duration of 4.5+/-3.3 years. The influence of HbA1c and reported insulin dose on blood pressure and heart rate were analyzed in multivariate linear regression models, statistically adjusted for the effect of race, sex, age, body mass index, and duration of diabetes. There was a significant positive correlation of mean HbA1c with mean diastolic blood pressure (P<.025) and mean heart rate (P<.0004). Higher diastolic blood pressure and heart rate were associated with higher HbA1c. Increased insulin doses were also associated with increased diastolic blood pressure (P<.009) and heart rate (P<.013). Insulin dose and HbA1c were also significantly correlated (P<.001). There was no correlation between mean HbA1c and mean systolic blood pressure. Increased levels of HbA1c and insulin dose are associated with increased diastolic blood pressure and heart rate. Although within the normal range, early increases of diastolic blood pressure and heart may indicate early cardiovascular changes in response to diabetes and potentially contribute to a greater proclivity for later development of nephropathy.
authors.affiliation: Pediatric Endocrinology/Diabetes, Department of Pediatrics, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans, LA 70118, USA.
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Torchinsky
authors.forename: Ricardo
authors.initials: R
authors.lastname: Gomez
authors.forename: Jay
authors.initials: J
authors.lastname: Rao
authors.forename: Alfonso
authors.initials: A
authors.lastname: Vargas
authors.forename: Donald E
authors.initials: DE
authors.lastname: Mercante
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Chalew
mesh_terms: D000293:Adolescent; D001741:Black or African American; D001786:Blood Glucose / Q000032:analysis*; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000503:physiopathology; D003971:Diastole; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006339:Heart Rate; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D016014:Linear Models; D008297:Male; D012189:Retrospective Studies; D044465:White People
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin