title: Association between insulin resistance and risk of complications in children and adolescents with type 1 diabetes.
abstract: BACKGROUND
  It has been hypothesized that insulin resistance may be involved in the development of type 1 diabetes complications and early diagnosis would be important for their prevention. Our aim was to study insulin resistance in our population of children with type 1 diabetes and to identify associated early risk factors for micro- and macrovascular complications.
  
  
  METHODS
  A descriptive, cross-sectional study was conducted including 150 children with type 1 diabetes. Anthropometric, bioelectric impedance, carotid Doppler ultrasonography, electromyography, and conduction velocity studies were performed. Baseline plasma glucose, lipid profile, uric acid, plasma thyrotropin, glycosylated hemoglobin A1C, and microalbuminuria were assessed. More insulin-resistant patients were defined as those having an estimated glucose disposal rate (eGDR) value below the first quartile.
  
  
  RESULTS
  Clinically manifest microvascular complications were not found in any of the patients. More insulin-resistant patients had a greater sub scapular fold thickness, a higher incidence of obesity (12% vs. 1.7% p 0.007), higher fructosamine levels (496 vs. 403 p<0.00019, and a higher incidence of altered lipid metabolism (70% vs. 39% p 0.0007).
  
  
  CONCLUSIONS
  In the subgroup of patients with lower eGDR there were more children with lipid disorders, obesity, and worse diabetic control, which, if not corrected, may lead to development of micro- and macrovascular complications.
authors.affiliation: Department of Clinical Nutrition, Hospital de Pediatría SAMIC J P Garrahan, Buenos Aires 1245, Argentina. Electronic address: gabkro66@hotmail.com.
authors.forename: Andrea G
authors.initials: AG
authors.lastname: Krochik
authors.affiliation: Department of Clinical Nutrition, Hospital de Pediatría SAMIC J P Garrahan, Buenos Aires 1245, Argentina.
authors.forename: Marianela
authors.initials: M
authors.lastname: Botto
authors.affiliation: Department of Imaging, Hospital de Pediatría SAMIC J P Garrahan, Buenos Aires 1245, Argentina.
authors.forename: Mónica
authors.initials: M
authors.lastname: Bravo
authors.affiliation: Department of Hematology and Oncology, Laboratory of Hemostasis and Thrombosis, Hospital de Pediatría SAMIC J P Garrahan, Buenos Aires 1245, Argentina.
authors.forename: Mirta
authors.initials: M
authors.lastname: Hepner
authors.affiliation: Department of Hematology and Oncology, Laboratory of Hemostasis and Thrombosis, Hospital de Pediatría SAMIC J P Garrahan, Buenos Aires 1245, Argentina.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Frontroth
authors.affiliation: Department of Neurology, Unit of Electrophysiology, Hospital de Pediatría SAMIC J P Garrahan, Buenos Aires 1245, Argentina.
authors.forename: Miguel
authors.initials: M
authors.lastname: Miranda
authors.affiliation: Department of Clinical Nutrition, Hospital de Pediatría SAMIC J P Garrahan, Buenos Aires 1245, Argentina.
authors.forename: Carmen
authors.initials: C
authors.lastname: Mazza
mesh_terms: D000293:Adolescent; D000419:Albuminuria / Q000097:blood / Q000175:diagnosis; D001118:Argentina / Q000453:epidemiology; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism*; D003925:Diabetic Angiopathies / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D042241:Early Diagnosis; D005260:Female; D019270:Fructosamine / Q000097:blood; D006442:Glycated Hemoglobin / Q000378:metabolism; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D050356:Lipid Metabolism; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors; D012885:Skinfold Thickness; D014527:Uric Acid / Q000097:blood
chemical_list: D001786:Blood Glucose; D019270:Fructosamine; D006442:Glycated Hemoglobin; D014527:Uric Acid; C517652:hemoglobin A1c protein, human
keywords: Children; Complications; Insulin resistance; Type 1 diabetes