Microvascular Disease in Children and Adolescents with Type 1 Diabetes and Obesity

Overview

Journal Pediatr Nephrol

Specialties Nephrology
Pediatrics

Date 2010 Aug 20

PMID 20721674

Citations 12

Authors

M Loredana Marcovecchio

Francesco Chiarelli

Affiliations

Soon will be listed here.

Abstract

The incidence of type 1 diabetes (T1D) is increasing worldwide and is associated with a significant burden, mainly related to the development of vascular complications. Over the last decades, concomitant with the epidemic of childhood obesity, there has been an increasing number of cases of type 2 diabetes (T2D) among children and adolescents. Microvascular complications of diabetes, which include nephropathy, retinopathy and neuropathy, are characterized by damage to the microvasculature of the kidney, retina and neurons. Although clinically evident microvascular complications are rarely seen among children and adolescents with diabetes, there is clear evidence that their pathogenesis and early signs develop during childhood and accelerate during puberty. Diabetic vascular complications are often asymptomatic during their early stages, and once symptoms develop, there is little to be done to cure them. Therefore, screening needs to be started early during adolescence and, in the case of T2D, already at diagnosis. Identification of risk factors and subclinical signs of complications is essential for the early implementation of preventive and therapeutic strategies, which could change the course of vascular complications and improve the prognosis of children, adolescents and young adults with diabetes.

Citing Articles

D1S-Neuro Program: Frequency and Risk Factors for the Development of Diabetic Neuropathy in Pediatric Patients with Type 1 Diabetes Mellitus, a Single Center Study.

Piccoli M, Gutierrez De Rubalcava Doblas J, Furlan P, Cocchio S, Zamberlan A, Panzeri G Biomedicines. 2025; 13(1.

PMID: 39857602 PMC: 11762328. DOI: 10.3390/biomedicines13010019.

Slowing of Peripheral Nerve Conduction Velocity in Children and Adolescents With Type 1 Diabetes Is Predicted by Glucose Fluctuations.

Oberhauser S, lAllemand D, Willems E, Gozzi T, Heldt K, Eilers M Diabetes. 2023; 72(12):1835-1840.

PMID: 37699386 PMC: 10658059. DOI: 10.2337/db23-0063.

SGLT2 Inhibitor-Dapagliflozin Attenuates Diabetes-Induced Renal Injury by Regulating Inflammation through a CYP4A/20-HETE Signaling Mechanism.

Dia B, Alkhansa S, Njeim R, Al Moussawi S, Farhat T, Haddad A Pharmaceutics. 2023; 15(3).

PMID: 36986825 PMC: 10054805. DOI: 10.3390/pharmaceutics15030965.

Peripheral and Autonomic Neuropathy Status of Young Patients With Type 1 Diabetes Mellitus at the Time of Transition From Pediatric Care to Adult-Oriented Diabetes Care.

Vagvolgyi A, Maroti A, Szucs M, Poczik C, Urban-Pap D, Baczko I Front Endocrinol (Lausanne). 2021; 12:719953.

PMID: 34512550 PMC: 8430208. DOI: 10.3389/fendo.2021.719953.

Association of plasminogen activator inhibitor-1 4G5G Polymorphism with risk of diabetic nephropathy and retinopathy: a systematic review and meta-analysis.

Dastgheib S, Najafi F, Shajari A, Bahrami R, Asadian F, Sadeghizadeh-Yazdi J J Diabetes Metab Disord. 2021; 19(2):2005-2016.

PMID: 33520873 PMC: 7843759. DOI: 10.1007/s40200-020-00675-1.

References

Stehouwer C, Lambert J, Donker A, van Hinsbergh V . Endothelial dysfunction and pathogenesis of diabetic angiopathy. Cardiovasc Res. 1997; 34(1):55-68. DOI: 10.1016/s0008-6363(96)00272-6. View

Seaquist E, Goetz F, Rich S, Barbosa J . Familial clustering of diabetic kidney disease. Evidence for genetic susceptibility to diabetic nephropathy. N Engl J Med. 1989; 320(18):1161-5. DOI: 10.1056/NEJM198905043201801. View

Gorman D, Sochett E, Daneman D . The natural history of microalbuminuria in adolescents with type 1 diabetes. J Pediatr. 1999; 134(3):333-7. DOI: 10.1016/s0022-3476(99)70459-2. View

Ciulla T, Amador A, Zinman B . Diabetic retinopathy and diabetic macular edema: pathophysiology, screening, and novel therapies. Diabetes Care. 2003; 26(9):2653-64. DOI: 10.2337/diacare.26.9.2653. View

Coonrod B, Ellis D, Becker D, Bunker C, Kelsey S, Lloyd C . Predictors of microalbuminuria in individuals with IDDM. Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes Care. 1993; 16(10):1376-83. DOI: 10.2337/diacare.16.10.1376. View

Viberti G, Jarrett R, Keen H . Microalbuminuria as prediction of nephropathy in diabetics. Lancet. 1982; 2(8298):611. DOI: 10.1016/s0140-6736(82)90688-2. View

Hietala K, Harjutsalo V, Forsblom C, Summanen P, Groop P . Age at onset and the risk of proliferative retinopathy in type 1 diabetes. Diabetes Care. 2010; 33(6):1315-9. PMC: 2875446. DOI: 10.2337/dc09-2278. View

Savino A, Pelliccia P, Chiarelli F, Mohn A . Obesity-related renal injury in childhood. Horm Res Paediatr. 2010; 73(5):303-11. DOI: 10.1159/000308161. View

Mogensen C . Microalbuminuria, blood pressure and diabetic renal disease: origin and development of ideas. Diabetologia. 1999; 42(3):263-85. DOI: 10.1007/s001250051151. View

10.

Donaghue K, Fairchild J, Craig M, Chan A, Hing S, Cutler L . Do all prepubertal years of diabetes duration contribute equally to diabetes complications?. Diabetes Care. 2003; 26(4):1224-9. DOI: 10.2337/diacare.26.4.1224. View

11.

Mohamed Q, Gillies M, Wong T . Management of diabetic retinopathy: a systematic review. JAMA. 2007; 298(8):902-16. DOI: 10.1001/jama.298.8.902. View

12.

Nathan D, Genuth S, Lachin J, Cleary P, Crofford O, Davis M . The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993; 329(14):977-86. DOI: 10.1056/NEJM199309303291401. View

13.

Herold Gallego P, Craig M, Hing S, Donaghue K . Role of blood pressure in development of early retinopathy in adolescents with type 1 diabetes: prospective cohort study. BMJ. 2008; 337:a918. PMC: 2526183. DOI: 10.1136/bmj.a918. View

14.

Marcovecchio M, Dalton R, Prevost A, Acerini C, Barrett T, Cooper J . Prevalence of abnormal lipid profiles and the relationship with the development of microalbuminuria in adolescents with type 1 diabetes. Diabetes Care. 2009; 32(4):658-63. PMC: 2660471. DOI: 10.2337/dc08-1641. View

15.

Yokoyama H, Okudaira M, Otani T, Sato A, Miura J, Takaike H . Higher incidence of diabetic nephropathy in type 2 than in type 1 diabetes in early-onset diabetes in Japan. Kidney Int. 2000; 58(1):302-11. DOI: 10.1046/j.1523-1755.2000.00166.x. View

16.

Nordwall M, Hyllienmark L, Ludvigsson J . Early diabetic complications in a population of young patients with type 1 diabetes mellitus despite intensive treatment. J Pediatr Endocrinol Metab. 2006; 19(1):45-54. DOI: 10.1515/jpem.2006.19.1.45. View

17.

Tesfaye S, Stevens L, Stephenson J, Fuller J, Plater M, Ionescu-Tirgoviste C . Prevalence of diabetic peripheral neuropathy and its relation to glycaemic control and potential risk factors: the EURODIAB IDDM Complications Study. Diabetologia. 1996; 39(11):1377-84. DOI: 10.1007/s001250050586. View

18.

Trotta D, Verrotti A, Salladini C, Chiarelli F . Diabetic neuropathy in children and adolescents. Pediatr Diabetes. 2004; 5(1):44-57. DOI: 10.1111/j.1399-543X.2004.00041.x. View

19.

Nordwall M, Bojestig M, Arnqvist H, Ludvigsson J . Declining incidence of severe retinopathy and persisting decrease of nephropathy in an unselected population of Type 1 diabetes-the Linköping Diabetes Complications Study. Diabetologia. 2004; 47(7):1266-1272. DOI: 10.1007/s00125-004-1431-6. View

20.

Bonnet F, Cooper M . Potential influence of lipids in diabetic nephropathy: insights from experimental data and clinical studies. Diabetes Metab. 2000; 26(4):254-64. View