Document Detail

Identifying children at particular risk of long-term diabetes complications.
MedLine Citation:
PMID:  17727384     Owner:  NLM     Status:  MEDLINE    
Formerly a 'taboo' subject, long-term complications are now being increasingly discussed with the family by the health-care team. Identifying potential predictors and establishing early intervention can change the course of these complications in the young patient with diabetes. Although the most recognized risk factor is glycaemic exposure, the development of diabetes complications is likely to result from an interaction between genetic and environmental factors. Other major environmental risk factors are hypertension, smoking, higher body mass index and lipid disorders. This article will concentrate on specific paediatric aspects, including the impact of puberty; endothelial dysfunction and genetic susceptibility. Endothelial function assessed by flow-mediated dilatation is a non-invasive method that has been suitable for use in children and adolescents. In type 1 diabetes mellitus children, endothelium dysfunction has been documented among patients with short diabetes duration and has been correlated to folate status, triglyceride and low-density lipoprotein cholesterol levels. Studies in the paediatric population have also revealed an association of diabetes complications with genetic variants in the renin-angiotensin system, polyol pathway, lipid oxidation and folate metabolism. Currently, achieving the best glycaemic control remains the gold standard for prevention of long-term diabetes complications in the clinical context. However, recent identification of genetic markers and development of research tools that predict long-term complications might have a potential role as instruments in assessing the effectiveness of intervention in the early course of the disease.
Patrica H Gallego; Esko Wiltshire; Kim C Donaghue
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Pediatric diabetes     Volume:  8 Suppl 6     ISSN:  1399-543X     ISO Abbreviation:  Pediatr Diabetes     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-08-30     Completed Date:  2008-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100939345     Medline TA:  Pediatr Diabetes     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  40-8     Citation Subset:  IM    
Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Sydney, Australia.
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MeSH Terms
Diabetes Complications / diagnosis*,  genetics
Endothelium / metabolism,  pathology
Mass Screening
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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