What is the clinical evidence from this study?

Study design: Case-Control. Population: Type 1 Diabetes Mellitus (n=40). Intervention: Type 1 Diabetes Mellitus vs. Healthy controls. Primary outcome: P-wave dispersion (ms) (p=<0.001).

What question did this study set out to answer?

The aim was to evaluate early electrical alterations in children with type 1 diabetes using electrocardiographic parameters and dispersion indices.

June 14, 2026Koşuyolu Heart Journal0 citationsOpen Access

Cardiovascular Involvement in Children with Type 1 Diabetes Mellitus: Insights from Cardiac Electrophysiological Balance and Electrocardiographic Parameters

Q: What are the key findings of this study?

Children with type 1 diabetes mellitus had significantly higher P-wave, QTc, and Tp-e dispersion compared to healthy controls, indicating early subclinical electrical heterogeneity.

Q: What question did this study set out to answer?

The aim was to evaluate early electrical alterations in children with type 1 diabetes using electrocardiographic parameters and dispersion indices.

ŞAŞule ArıcıKartal Koşuyolu High Specialization Training and Research Hospital FGFatih Alparslan GençKartal Koşuyolu High Specialization Training and Research Hospital GKGülperi Yağar KeskinKartal Koşuyolu High Specialization Training and Research Hospital

Key Result

Children with type 1 diabetes mellitus had significantly higher P-wave, QTc, and Tp-e dispersion compared to healthy controls, indicating early subclinical electrical heterogeneity.

Key Points

The aim was to evaluate early electrical alterations in children with type 1 diabetes using electrocardiographic parameters and dispersion indices.
Prospective case-control design assessing 20 children with T1DM and 20 healthy controls
Transthoracic echocardiography and 12-lead ECG were performed
Dispersion indices and electrophysiological measures were quantified and correlated with clinical variables.
Children with T1DM had significantly higher P-wave, QTc, and Tp-e dispersion (all p<0.001) compared to controls.
Diabetes duration correlated positively with P-wave dispersion (r=0.489, p=0.029) while HbA1c correlated inversely with QT/QRS (r=-0.475, p=0.034).
Conventional echocardiographic parameters were normal in both groups.

Study Design

Type

Case-Control (n=40)

Multicenter

Structured PICO

Does Type 1 Diabetes Mellitus cause early subclinical electrical alterations on electrocardiography in children?

Population

40 children, comprising 20 with type 1 diabetes mellitus and 20 age- and sex-matched healthy controls, evaluated for early subclinical cardiac electrophysiological alterations.

Exposure

Type 1 Diabetes Mellitus (disease exposure)

Comparator

Age- and sex-matched healthy controls with no known systemic disease and normal clinical, echocardiographic, and electrocardiographic findings

Outcome

Early, subclinical electrical alterations on electrocardiography (P-wave, QTc, and Tp-e dispersion; Tp-e/QT and Tp-e/QTc ratios; and QT/QRS and QTc/QRS electrophysiological balance indices)surrogate

Pediatric patients with Type 1 Diabetes Mellitus exhibit subclinical electrocardiographic abnormalities, including increased dispersion indices, suggesting early myocardial electrical heterogeneity despite normal echocardiographic findings.

Main Result

Absolute Event Rate: 44.7% vs 28.9%

p-value: p=<0.001

Limitations

Relatively small sample size
Single-center design
Cross-sectional nature of the analysis precludes causal inferences
Absence of long-term rhythm monitoring

Abstract

Objective: We examined whether children with type 1 diabetes mellitus (T1DM) demonstrated early, subclinical electrical alterations on electrocardiography by evaluating dispersion indices, ventricular repolarization markers, and electrophysiological balance measures. Methods: In this prospective case–control study, 20 children with T1DM and 20 age- and sex-matched healthy controls underwent transthoracic echocardiography and 12-lead electrocardiogram (ECG). We quantified P-wave, QTc, and Tp–e dispersion; Tp–e/QT and Tp–e/QTc ratios; and electrophysiological balance indices (QT/QRS and QTc/QRS). Relationships between ECG indices and clinical variables (diabetes duration and glycated hemoglobin HbA1c) were assessed. Results: Conventional echocardiographic parameters were normal in both groups. Compared with controls, children with T1DM had higher P-wave dispersion, QTc dispersion, and Tp–e dispersion (all p<0.001), whereas Tp–e-based ratios and electrophysiological balance indices were similar between groups. Diabetes duration correlated positively with P-wave dispersion (r=0.489, p=0.029), and HbA1c correlated inversely with QT/ QRS (r=-0.475, p=0.034). Conclusion: Pediatric T1DM may be accompanied by subtle ECG abnormalities despite preserved conventional echocardiographic findings. Increased dispersion indices support early electrical heterogeneity, and the association between electrophysiological balance and glycemic control suggests an effect of metabolic burden on myocardial electrical stability.

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