Reduced vascular reactivity in diabetic children and its relation to diabetic control.

Abstract

The vascular reactivity in response to ischaemia was studied by a non-invasive method of measuring transcutaneous oxygen tension used at 37 degrees C, in 28 children with type I diabetes mellitus. Postischaemic hyperaemia was significantly reduced in the diabetic children compared with 34 healthy children. The degree of reduction in vascular reactivity correlated to both short-term and long-term diabetic control. Among tested variables, urinary glucose excretion during the night preceding the test showed the highest coefficient of correlation to the peak of the postocclusive reactive hyperaemia (r = -0.59, p less than 0.01). This peak was only weakly correlated to triglycerides and glycosylated haemoglobins and showed no significant correlation to fasting plasma glucose or to the duration of the disease. It was weakly correlated to the total daily insulin dosage but not to the dosage of insulin/kg body weight. Multiple linear regression analysis revealed that urinary glucose excretion, plasma glucose, haemoglobin A1, serum triglyceride and serum cholesterol, duration of diabetes, and insulin dosage per kg body weight together explained 54% of the variation in vascular reactivity. The reduced vascular reactivity found in diabetic children could not be explained by the usual parameters of carbohydrate control alone. This new non-invasive method is able to reveal a reduction in vascular function in diabetic children and should therefore be of value in attempts to find the causes of vascular dysfunction in diabetics.