Vascular Abnormality Seen in Type 1 Diabetic Children

Forearm blood flow, measured by near-infrared spectroscopy, is reduced in children and adolescents with type 1 diabetes who have no other clinical signs of vasculopathy. Near-infrared spectroscopy (NIRS) has been used to demonstrate impaired peripheral muscle blood flow in adult patients with diabetes, peripheral vascular disease, and heart failure, Dr. Gerhard Pichler and colleagues from the University of Graz, Austria, explain.

The researchers measured muscle blood flow by NIRS in 40 children and adolescents aged 6 to 18 years with type 1 diabetes and in 40 healthy children and adolescents. Forearm blood flow at rest was significantly lower in the diabetic group, the authors report. Also, the exercise-induced increase in forearm blood flow was significantly lower in the diabetic group, and the changes after exercise tended to decline with increasing duration of diabetes.

Forearm blood flow did not differ between female and male patients, the researchers note, and forearm blood flow at rest and after exercise were independent of body-mass index, hemoglobin concentration, blood glucose levels, hemoglobin A1c, blood pressure, and heart rate.

“With the data from the present study,” the investigators write, “it is not possible to distinguish whether the reduced forearm blood flow in children and adolescents with type 1 diabetes is due to metabolic, vascular, or neurogenic disorders. Most probably, the reduced forearm blood flow is due to a combination of all three factors.”

“In children and adolescents with type 1 diabetes who have no other clinical signs,” the authors conclude, “this method is promising, well tolerated, and noninvasive when assessing disorders of muscular perfusion.” Diabetes Care 2004;27:1942-1946.