Abstract

Aim. Glucose variability (GV) and hypoglycaemia frequency and duration, depending on cardiovascular autonomic dysfunction, in children and adolescents with type 1 diabetes mellitus (T1DM) were evaluated. Materials and methods. One hundred and thirty T1DM patients, aged 6-18 years, were included in this study. The study included 3 tests: 1) continuous glucose monitoring (CGM) with GV evaluation, frequency and duration of hypoglycaemia; 2) 24-h ECG monitoring with automatic calculation of QTc interval and heart rate variability (HRV) parameters and 3) cardiovascular autonomic tests. Results. The estimated prevalence of cardiovascular autonomic neuropathy (CAN) was 19.2%. CAN positive (CAN+) patients had lower values from cardiovascular autonomic tests and HRV and longer QTc intervals compared with CAN negative (CAN-) patients (p 10 mmol/l) (p <0.05). In CAN+ patients, the frequency and duration of hypoglycaemia were higher compared with CANpatients (p <0.05). GV and hypoglycaemia were positively associated with autonomic dysfunction in multiple regression models (p <0.05). Conclusion. In this study, the presence of CAN was associated with increased GV and higher hypoglycaemia frequency and duration. This data suggest that GV and/or hypoglycaemia may contribute to impaired cardiovascular autonomic function. This can have an impact on the determination of individual blood glucose targets in patients with T1DM and CAN.

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