Fatores de risco metabólico e cardiovascular associados à Diabetes Mellitus tipo 1 em idade pediátrica

Abstract

According to International Diabetes Federation (IDF), in 2019, there was an average of 463 million people with diabetes, of which over 1,110,100 are children and teenagers with Type 1 Diabetes Mellitus (T1DM) (aged between 0-19 years old), accounting for 128,900 new diagnoses per year. Europe has the greatest number of children and teens with T1DM (296 500 cases), of which 2 552 were from Portugal during 2019. It is well known that Diabetes is a risk factor for cardiovascular disease. Children with diabetes tend have another cumulative risk factor that places then in a higher risk group when compared to their healthy peers (more weight excess and/or obesity, more prevalence of metabolic syndrome features and more endothelial disfunction at younger age). This Review aims to sum up some scientific evidence from randomized controlled trials and systematic reviews that show that that is, in fact, a higher prevalence of dyslipidemia, weight gain, changes in tensional profile and early atherosclerotic features and endothelial disfunction among children and teenagers with T1DM when compared to children with the same age without this disease. More importantly, this article attempts to focus on the importance of preventing this cardiovascular morbidity and mortality that is imposed by the disease at such a young age. Therefore, there is a growing need to keep investing in the continuous glucose monitoring systems along with intensive insulin regimens that provide a much more stable and physiological glycemic profile, diminishing the side effects of hyperglycemia and insulin administration in such young ages. Therefore, it is expected a growing concern about prevention and retardation of cardiovascular morbidity and premature mortality that accompanies T1DM. This can be accomplished allying a healthy diet, regular physical activity, as well as physiological and individualized insulin regimens. Eventually, as the technology and scientific knowledge continues to evolve, we are going to be able to give a better care and a longer and healthier life to children and teens with T1DM, minimizing the cumulative risk factors and putting them nearer the pediatric population without this disease.