Table of Contents
ISRN Endocrinology
Volume 2013 (2013), Article ID 876547, 7 pages
http://dx.doi.org/10.1155/2013/876547
Research Article

Effects of Glucose Control and Variability on Endothelial Function and Repair in Adolescents with Type 1 Diabetes

1Department of Pediatrics, The Ohio State University, The Research Institute at Nationwide Children's Hospital, 700 Children’s Drive, ED422, Columbus, OH 43205, USA
2Department of Pediatrics, West Virginia University, 830 Pennsylvania Avenue Suite 104, Charleston, WV 25302, USA
3Research Institute at Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA

Received 11 September 2013; Accepted 8 October 2013

Academic Editors: G. Chiari, O. Giampietro, and M. Prazny

Copyright © 2013 Robert P. Hoffman et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Endothelial dysfunction and increased inflammation are precursors of cardiovascular disease in type 1 diabetes (T1D) and occur even in adolescents with T1D. The goal of this study was to determine the relationship of endothelial dysfunction to various measures of glycemia. Research Design and Methods. Forearm blood flow (FBF, venous occlusion plethysmography) was measured before and after 5 min of upper arm vascular occlusion in 17 adolescents with uncomplicated type 1 diabetes. Endothelial function was assessed as postocclusion FBF and forearm vascular resistance (FVR, mean arterial pressure/FBF). Fasting glucose, 72 hour mean glucose and standard deviation from continuous glucose monitoring, hemoglobin A1c, and hemoglobin A1c by duration area under the curve were used to assess immediate, short-term, and intermediate- and long-term glycemia. Results. Postocclusion FBF ( , ) negatively correlated and postocclusion FVR positively correlated ( , ) with hemoglobin A1c levels. FVR was positively associated with log 3 day mean glucose ( , ). Postocclusion FBF ( versus  mL/dL/min, mean ± SE, ) tended to be lower and FVR ( versus  mmHg dL min/mL, ) was significantly higher in subjects with hemoglobin A1c above the median (8.3%) compared to those with lower hemoglobin A1c levels. Conclusions. These results demonstrate that poor intermediate-term glycemic control is associated with impaired endothelial function.