Microvascular autoregulation in children and adolescents with type 1 diabetes mellitus

Diabetologia. 2012 Jun;55(6):1633-40. doi: 10.1007/s00125-012-2502-8. Epub 2012 Feb 26.


Aims/hypothesis: Deterioration of microvascular function may have an early onset in individuals with type 1 diabetes mellitus. We hypothesised that microvascular autoregulation is impaired in children with type 1 diabetes and can be detected non-invasively by postocclusive reactive hyperaemia (PORH).

Methods: Microvascular autoregulation was assessed in 58 children with type 1 diabetes and 58 age- and sex-matched healthy controls by PORH using laser Doppler fluxmetry. Baseline perfusion, biological zero (defined as a 'no flow' laser Doppler signal during suprasystolic occlusion), peak perfusion following occlusion, time to peak and recovery time (time until baseline perfusion is resumed) were recorded and compared between the groups.

Results: Peak perfusion was higher in children with type 1 diabetes than in healthy controls (1.7 ± 0.93 AU [arbitrary units] vs 1.29 ± 0.46 AU; p = 0.004), and biological zero was lower in children with type 1 diabetes vs controls (0.14 ± 0.04 AU vs 0.19 ± 0.04 AU; p < 0.0001). No differences were seen between the groups in baseline perfusion, time to peak during PORH and recovery time following PORH.

Conclusions/interpretation: PORH reveals impaired microvascular autoregulation in children with type 1 diabetes. The higher peak perfusion might reflect a decline in the vasoconstrictive ability of arteriolar smooth muscle cells upstream of capillary beds in children with type 1 diabetes.

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Child
  • Diabetes Mellitus, Type 1 / physiopathology
  • Female
  • Homeostasis / physiology*
  • Humans
  • Laser-Doppler Flowmetry
  • Male
  • Microcirculation / physiology*