INVOLVEMENT OF CARDIAC FUNCTION AND AUTONOMIC NERVOUS SYSTEM IN CHILDREN WITH INSULIN-DEPENDENT DIABETES MELLITUS

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We assessed the functions of both the cardiac and the autonomic nervous system in children with insulin-dependent diabetes mellitus (IDDM) and age-matched control subjects, using noninvasive methods. The function of the autonomic nervous system was examined by measuring the R-R intervals and the orthostatic blood pressure response. The cardiac function was examined by measuring cardiac output in the lying and standing position. The cardiac output was measured by impedance cardiography. According to the level of glycosylated hemoglobin (HbA1), the subjects were divided into a well-controlled group (HbA1 < 10%, N = 17) and a poorly controlled group (HbA1 > 10%, N = 15). Both diabetic groups showed a significant elevation of the cardiac output at rest (P <0.05). In the standing position, the poorly controlled group showed a significant decrease in the systolic blood pressure, and a slight increase in the diastolic blood pressure. On the other hand, the levels of CVr-r in the poorly controlled group were significantly lower than those in the normal control as well as the well-controlled group (P <0.01). In addition, the levels of CVr-r in the diabetic group had a significant negative correlation with the HbA1 values (r =-0.67, P < 0.01). We conclude that involvement of the autonomic nervous system in IDDM children may develop earlier than that of the cardiac system, which we had not expected.
北関東医学会の論文