IMPE Abstracts

Up to 45% of youth with type 1 diabetes (T1D) have cardiovascular (CV) risk factors and may develop subclinical cardiovascular disease in the first decade of diagnosis. Physical fitness in youth have been shown to be associated with cardiometabolic risks factors among youths with and without diabetes.

Aim: To examine the association between handgrip strength and cardiorespiratory fitness and the compliance of the ADA/ISPAD clinical guideline goals on CV risk factors in a cohort of children and adolescents with T1D living in the Autonomous Community of Navarra, Spain.

Methods: Patients with T1D aged 6 to 18 years, with at least 6 months since diagnosis were invited to participate in the Diactive-1 study. Strength was assessed through handgrip test and cardiorespiratory fitness (VO2peak) by an incremental exercise test in cycle ergometer using the K4b2 gas analyzer Cosmed®. The lipid profiles and A1c levels were obtained from the medical records. A pediatrician determined the body mass index (BMI) and measured the blood pressure. A linear regression with a bootstrapping method was used to determine associations between the variables.

Results: Eighty-two participants were included, mean age was 12.8 years (± 2.764), 33 (44.6%) were female, and mean duration of the disease was 4.89 years (±3.44). The proportion of patients complying with each of the ADA/ISPAD goals was: 23 (28%) A1c, 59 (72%) blood pressure, 46 (56.1%) LDL, 76 (92.7%) HDL, 82 (100%) Triglycerides, 69 (84.1%) BMI, and only 9 (11%) comply with all criteria. Cardiorespiratory fitness (35.42; ±8.629) was associated with higher compliance of ADA criteria (β= 0.033; P= 0.025; 95%CI: 0.005 to 0.060). No association was found between handgrip strength (0.4177; ±0.078) and compliance of ADA/ISPAD criteria (β=2.72; P= 0.069; 95%CI: -0.196 TO 5.550).

Conclusions: Despite the young age and relative short duration of the disease, there is a high prevalence of CV risk factors among the patients of our cohort. The association between cardiorespiratory fitness and a better cardiovascular profile in terms of compliance of ADA/ISPAD goals highlights the importance of the promotion of physical activity since diagnosis among these youths as a key element of primary prevention of cardiovascular disease.