Spectrum and characteristics of the electrocardiographic changes in children with type I diabetes mellitus

Abstract

Introduction. Type I diabetes mellitus (T1D) is one of the most widespread and socially significant diseases. Well-known as a co-occurring condition with youth- onset type 1 diabetes mellitus, cardiovascular disease manifests early after initial diagnosis as signs of cardiovascular remodeling. Growing data indicates that type 1 diabetic children and young adults experience subclinical heart dysfunction, central aortic stiffening, and accelerated peripheral vascular disease. Increased morbidity and mortality in adults have been linked to peripheral artery, heart, and cerebrovascular diseases, and early vascular alterations have been demonstrated to exist since childhood. Little is known to date concerning the development of early cardiac structural and functional problems in children with T1D. Early diagnostic is of high importance. Aim. To assess the frequency and spectrum of electrocardiography (ECG) abnormalities in children with type 1 diabetes. Materials and methods. Records of 60 patients with type I diabetes included into the analysis. ECG data, main anamnestic, clinical and laboratory data analyzed. Results. So-called «small ECG abnormalities» were found. Incomplete left/right blockade bundle branch block found in 22.5 % of children, shortened PQ interval in 15 %, extrasystoles, tachycardia, bradycardia in 52.5 %, T wave amplitude decrease in 60 %. 87.5 % of the examinees have a combination of 2-3 of the above changes on the ECG. Only 12 % of the examined children had an ECG without pathological changes. All children with newly diagnosed type 1 DM had at least 1 of the described ECG abnormalities. Correlation analysis done. Substantial positive correlations between Hb1Ac levels and number of ECG changes, serum cholesterol levels and number of ECG changes were found. Conclusions. The results of the study indicate that the majority of children with type I diabetes have so-called «small ECG abnormalities.» According to the type of disturbances, they can be classified as rhythm and conduction disturbances and combined changes. These findings are promising in terms of management tactics for children with type I diabetes, early detection and timely therapeutic correction of ECG abnormalities.