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[Early detection of changes in peripheral blood vessels in children and adolescents with insulin-dependent diabetes mellitus using Doppler ultrasound].

A clinically established method for early diagnosis of a macroangiopathy in a preclinical state has not been available so far. It was therefore checked whether vascular changes in diabetics can already be detected in childhood and adolescence by determination of pulse wave velocity using the Doppler ultrasound technique. The pulse wave velocity (PWV) was determined in 63 diabetics with a mean age (mean +/- s) of 16.2 +/- 3.3 years and a mean duration of diabetes (mean +/- s) of 8.5 +/- 4.7 years and in 45 control subjects with a mean age of 15.8 +/- 3.8 years by simultaneous recording of the pulse curves from the femoral artery and the posterior tibial artery. The diabetics had a very much higher PWV than the control group (mean +/- s: 10.9 +/- 1.6 m/s as compared to 9.9 +/- 0.8 m/s; p less than 0.001). In 21 out of 63 diabetics, the values were above the 2s range of controls. Indeed, nine of these 21 patients had values above the 3s range. In the diabetics, there was a significant correlation between PWV and the duration of diabetes and mean blood pressure. Vascular changes can already be demonstrated in childhood and adolescence by measurement of the PWV using the Doppler ultrasound method in diabetics. A longitudinal study would be necessary to establish whether this enables early diagnosis of macroangiopathy.