Alterations of Sublingual Microcirculation in Children With Compensated Type 1 Diabetes Mellitus—An Observational Study

Introduction Type 1 diabetes is commonly associated with microvascular complications. Sublingual microcirculation examination using sidestream dark‐field (SDF) imaging can reflect the situation in visceral microcirculation. The main goals of this observational study were to assess the feasibility of SDF imaging in children with compensated type 1 diabetes, determine selected sublingual microcirculation parameters, and compare them with parameters obtained in healthy children. Methods In total 30 children with stable type 1 diabetes without clinical or laboratory signs of microvascular complications were included in the study, 15 males and 15 females in three age categories. Three video clips were recorded using an SDF probe from different parts of the sublingual area and analyzed by software‐aided offline analysis. Results Videoclips were successfully recorded in all children. Compared with healthy children, the De Backer score (DeBS) in females and total vessel density (TVD), small vessel density (SVD), perfused vessel density (PVD), and perfused SVD (PSVD) in both genders were significantly lower in children with T1D. There were no differences in TVD, SVD, PVD, PSVD, and DeBS between age or gender categories. DeBS correlated with ketonemia; otherwise, no significant relationship was observed between microcirculatory and other recorded parameters. Conslusions Sublingual microcirculation examination using SDF imaging is feasible in children with type 1 diabetes. Alteration of sublingual microcirculatory parameters is detectable in children with type 1 diabetes before they show clinical or laboratory signs of any microvascular complication. Trial Registration ClinicalTrials.gov identifier: NCT05958264