The Influence of Diabetes Mellitus on Cardiovascular Function in Children and Adolescents

Abstract

Early manifestations of non-atherosclerotic cardiomyopathy, a recognized complication of diabetes in adults, have been suggested to contribute to depressed levels of aerobic fitness described in children and adolescents with this disease. This study measured components of aerobic fitness and cardiovascular function during maximal cycle ergometer exercise in 11 insulin-dependent diabetic boys aged 10.2-16.5 years. Mean duration of diabetes was 4.5 years. Eleven non-diabetic subjects matched for age, body size, and regular physical activity served as controls. No differences in maximal oxygen uptake or heart rate were observed between the two groups, nor were any significant differences recorded in submaximal stroke volume, cardiac output, heart rate, and pressure-rate product. This study failed to reveal any evidence of functional myocardial disease in children and young adolescents with diabetes, suggesting that manifestations of diabetic cardiomyopathy should not be expected during the pediatric years. Moreover, these findings indicating normal cardiovascular function in young diabetic subjects imply that regular levels of habitual physical activity are more likely to affect aerobic fitness in these patients rather than influences of the diabetic state itself.

Impaired Energy Expenditure Despite Normal Cardiovascular Capacity in Children with Type 1 Diabetes

“…Our results are in accordance with previous studies that did not show any difference in cardiovascular performance between children affected by T1DM and healthy pairs [29], and can suggest diastolic abnormalities as demonstrated in previous studies on females with T1DM [30]. …”

Diabetic Cardiomyopathy: A unique entity or a complication of coronary artery disease?

“…However, echocardiography and radionucleotide scanning have shown that the isovolumic relaxation time and left ventricular diastolic filling time are prolonged in asymptomatic diabetic patients with cardiac denervation (32,33), indicating that some or all of these changes could be due to cardiac denervation. Support for this theory can be found in studies of diabetic children and young adults in which no evidence of diabetic cardiomyopathy was found when diabetes was not accompanied by cardiac denervation, hypertension, or ischemic heart disease (34)(35)(36)(37).…”

Cardiac response to exercise in young, normal weight and overweight men and women

“…Overweight and obesity are associated with changes in cardiac structure and function (Licata et al 1992;Morricone et al 2002;Powell et al 2006;Rowland 2007) which may contribute to an increased risk of cardiovascular disease (Melanson et al 2001). In the early stages of obesity, there is an increase in blood volume which is accompanied by ventricular remodeling (Alaud-din et al 1990; Morricone et al 2002;Peterson et al 2004;Powell et al 2006) and diastolic dysfunction (Ferraro et al 1996;Licata et al 1992;Powell et al 2006;Sasso et al 2005).…”