Carotid intimo-medial thickness [cIMT] and correlation to cardiac risk factors in adolescent type 1 diabetics

Carotid intimo medial thickness (cIMT) is a sensitive screening tool for cardiac evaluation, but there are limited studies evaluating its role in type 1 diabetes mellitus (T1DM) in developing countries. Thirty diagnosed adolescent type 1 diabetics on conventional insulin regime were included. Their glycated hemoglobin (HbA1C) and lipid profile were measured. Their cardiovascular function (determined by cIMT) was estimated by echocardiography and was evaluated with the clinical and biochemical profile. The mean HbA1C was 8.01%; 18 patients had HbA1C >8%. The mean serum cholesterol, low density lipoprotein (LDL) and triglyceride were normal. The mean cIMT measured was 0.698 ± 0.233 mm. The mean cIMT was higher in patients with higher HbA1C (0.775 ± 0.21 mm) versus those with normal HbA1C (0.583 ± 0.22 mm); P = 0.019. The cIMT correlated significantly to systolic and diastolic blood pressure (P = 0.039 and 0.01). cIMT values were significantly related to serum cholesterol (P = 0.002) and serum LDL (P = 0.017). However, few patients with a normal metabolic profile also had raised cIMT >0.8 mm. cIMT was raised in few patients indicating onset of early cardiovascular changes in adolescence. Cardiovascular screening should be offered to type 1 adolescent diabetics early in the disease, irrespective of the metabolic parameters.