Abstract
Objective: To determine the relationship between mean arterial blood pressure (MAP) and blood viscosity in diabetic type 1 children and healthy controls to investigate whether MAP is independent of blood viscosity in healthy children, and vice versa.
Research design and methods: Children with diabetes type 1 treated by insulin injection were studied. Controls were healthy children of both sexes. MAP was calculated from systolic and diastolic pressure measurements. Blood viscosity was determined indirectly by measuring blood hemoglobin (Hb) content. The relationship between Hb, hematocrit (Hct) and blood viscosity was determined in a subgroup of controls and diabetics selected at random.
Results: 21 (10.6±2.5 years) type 1 diabetic children treated with insulin and 25 healthy controls age 9.6±1.7 years were studied. Hb was 13.8±0.8 g/dl in normal children vs. 14.3±0.9 g/dl in the diabetic group (p<0.05). MAP was 71.4±8.2 in the normal vs. 82.9±7.2 mmHg in the diabetic group (p<0.001). Glucose was 89.3±10.6 vs. 202.4±87.4 mg/dl respectively. Diabetics had a positive MAP/Hb correlation (p=0.007), while normals showed a non significant (p=0.2) negative correlation. The blood viscosity/Hb relationship was studied in a subgroup of 8 healthy controls and 8 diabetic type 1 children. There was no significant difference in Hb and Hct between groups. Diabetics showed a trend of increasing blood viscosity (+7%, p=0.15).
Conclusions: Normal children compensate for the increase in vascular resistance due to increased blood viscosity (increased Hb and Hct) while diabetic children do not, probably due to endothelial dysfunction.