Inflammation in pediatric patients with type 1 diabetes-An early predictor of complications?

Abstract

Type 1 diabetes is an autoimmune disease caused by the destruction of the pancreatic beta cells, and common complications include both microvascular (kidney disease, retinopathy, neuropathy) and macrovascular (peripheral arterial disease, coronary artery disease, stroke) disease. Hyperglycemia is a well-known risk factor for microvascular as well as macrovascular complications. However, even when glycemic control is improved, complications are not completely avoided, which has resulted in a theory of a 'metabolic memory.' Systemic inflammation is a common finding in patients with type 1 diabetes, and increased inflammatory markers appear even among children who have been recently diagnosed. Increased inflammatory cytokines have been found to be associated with later development of cardiovascular disease, diabetic nephropathy, retinopathy, and diabetic neuropathy, and may therefore act as a 'second hit' to hyperglycemia in the development of complications. Here we review the evidence for associations between inflammation and complications among children and youth with type 1 diabetes. © TOUCH BRIEFINGS 2009.