Longitudinal study of arterial stiffness in pediatric patients with Type 1 Diabetes Mellitus (T1DM). Correlations with glycemic metrics derived from Continuous Glucose Monitoring (CGM) devices

AIM To longitudinally investigate early indicators of cardiovascular disease (CVD) in youths with Type 1 Diabetes Mellitus (T1DM) and their associations with novel metrics derived from continuous glucose monitoring (CGM) systems. PATIENTS AND METHODS Eighty-seven patients (mean age: 10.72 ± 3.35 years), completed 3 visits at six-to-twelve-month intervals. In each visit, Pulse Wave Velocity (PWV) and Augmentation Index @75 (AIx@75) were quantified using a validated, non-invasive method, while glycemic parameters such as HbA1c, time in range (TIR), time above range (TAR) and time below range (TBR) were assessed in the trimester prior to the assessment. Patients were categorized according to TIR into TIR improvers: patients with constantly TIR ≥ 70% or constantly TIR ≥ 60% and improved by +≥10% from baseline versus TIR non-improvers and additionally according to HbA1c into HbA1c improvers: patients with constantly HbA1c ≤ 7% or constantly HbA1c ≤ 8% and improved by -≥0.8% from baseline versus HbA1c non-improvers. RESULTS TIR improvers showed significant improvement in Δ PWV Z-score according to age and in Δ Systolic Blood Pressure index. No significant difference was observed between HbA1c improvers and non-improvers. CONCLUSION New glycemic metrics seem to serve as more sensitive and early predictors of CVD in young patients with T1DM. Furter studies are needed to replicate and confirm these preliminary results.