Assessment of Microvascular Disturbances in Children with Type 1 Diabetes—A Pilot Study

TL;DR

This pilot study explores early microvascular changes in children with type 1 diabetes using new imaging techniques.

Contribution

The study introduces and evaluates novel techniques for detecting early microvascular disturbances in pediatric T1D patients.

Findings

T1D patients showed significantly increased wall thickness and wall-to-lumen ratio compared to controls.

A trend toward significance was observed between time in range and hyperemic response.

A correlation was found between carotid intima-media thickness and hyperemic response.

Abstract

Endothelial dysfunction appears early in type 1 diabetes (T1D). The detection of the first vascular disturbances in T1D patients is crucial, and the introduction of novel techniques, such as flow-mediated skin fluorescence (FMSF) and adaptive optics retinal camera (Rtx) imaging, gives hope for better detection and prevention of angiopathies in the future. In this study, we aimed to investigate microcirculation disturbances in pediatric patients with T1D with the use of FMSF and Rtx imaging. This research focused especially on the relationship between microvascular parameters obtained in FMSF and Rtx measurements, and the glycemic control evaluated in continuous glucose monitoring (CGM) reports. We observed significantly increased wall thickness (WT) and wall-to-lumen ratio (WLR) values in T1D patients in comparison to the control group. Although we did not observe significant differences between the T1D and control groups in the FMSF results, a trend toward significance between the time in range (TIR) and hyperemic response (HRmax) and an interesting correlation between the carotid intima-media thickness (cIMTmax) and HRmax. were observed. In conclusion, FMSF and Rtx measurments are innovative techniques enabling the detection of early microvascular disturbances.

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