Comparative Cardiovascular Impact of Early-Onset Type 1 and Type 2 Diabetes and Associated Risk Factors in Pediatric and Adult Patients

Cardiovascular Impact of Diabetes

Authors

  • Umar Shafiq Department of Pediatrics, Quaid-e-Azam Medical College, Bahawalpur, Pakistan
  • Ussama Munir Department of Cardiology, Quaid-e-Azam Medical College, Bahawalpur, Pakistan
  • Muhammad Naeem Department of Pediatrics, Quaid-e-Azam Medical College, Bahawalpur, Pakistan
  • Fazal Ur Rehman Department of Pediatric Cardiology, Quaid-e-Azam Medical College, Bahawalpur, Pakistan
  • Iftikhar Ahmad Department of Pediatrics, Quaid-e-Azam Medical College, Bahawalpur, Pakistan
  • Muhammad Adnan Zafar Department of Pediatrics, Quaid-e-Azam Medical College, Bahawalpur, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i7.3183

Keywords:

Early-Onset Diabetes, Cardiovascular Risk, Paediatric Patients, Type 1 And Type 2 Diabetes

Abstract

Cardiovascular disease is a leading cause of morbidity and mortality among individuals with diabetes, with early-onset cases posing unique risks. Objective: To evaluate and compare the cardiovascular impact of early-onset type 1 and type 2 diabetes mellitus in paediatric versus adult patients and to identify associated clinical, biochemical, and sociodemographic risk factors in a low-resource Pakistani setting. Methods: This was an observational, comparative, cross-sectional study conducted at the Department of Paediatrics, Quaid-e-Azam Medical College, Bahawalpur, from March 2024 to March 2025. A total of 260 participants were enrolled using non-probability consecutive sampling, comprising 130 diabetic patients (aged 10–40 years) with early-onset diabetes mellitus (diagnosed ≤25 years) and 130 age- and gender-matched healthy controls. Data were collected through structured clinical examination, laboratory investigations (including HbA1c, lipid profile, serum creatinine, urinary albumin-creatinine ratio), electrocardiography, and echocardiography. Statistical analysis was performed using SPSS version 26.0. Results: Diabetic patients demonstrated significantly higher prevalence of left ventricular hypertrophy (36.9% vs. 10.8%; adjusted OR: 5.01; 95% CI: 2.51–9.99; p = 0.0001), CIMT ≥0.9 mm (44.6% vs. 16.2%; OR: 4.49; 95% CI: 2.44–8.26; p = 0.0001), and diastolic dysfunction (24.6% vs. 6.9%; OR: 4.25; 95% CI: 1.83–9.89; p = 0.0003). Significant associations were found between cardiovascular complications and poor glycaemic control (HbA1c ≥7%), LDL ≥100 mg/dL, triglycerides ≥150 mg/dL, low socioeconomic status, and sedentary lifestyle. Conclusion: Early-onset diabetes mellitus is strongly associated with adverse cardiovascular outcomes in young Pakistani patients.

References

Lawrence JM, Divers J, Isom S, Saydah S, Imperatore G, Pihoker C et al. Trends in prevalence of type 1 and type 2 diabetes in children and adolescents in the US, 2001-2017. Journal of the American Medical Association. 2021 Aug; 326(8): 717-27. doi: 10.1001/jama.2021.11165.

Shah RD, Braffett BH, Tryggestad JB, Hughan KS, Dhaliwal R, Nadeau KJ et al. Cardiovascular risk factor progression in adolescents and young adults with youth-onset type 2 diabetes. Journal of Diabetes and its Complications. 2022 Mar; 36(3): 108123. doi: 10.1016/j.jdiacomp.2021.108123.

Kalra S, Gupta Y, Baruah MP. Cardiovascular disease in youth-onset type 2 diabetes mellitus. Indian Journal of Endocrinology and Metabolism. 2020; 24(1): 1-5. doi: 10.4103/ijem.IJEM_1_20.

Zubair M and Ahmad J. Potential risk factors and outcomes of infection with multidrug resistance among diabetic patients having ulcers: 7 years study. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019 Jan; 13(1): 414-8. doi: 10.1016/j.dsx.2018.10.014.

Silva DF, Oliveira JEP, Souza CF. Cardiovascular risk in adolescents and young adults with type 1 diabetes mellitus. Arq Bras Cardiol. 2021; 116(1): 30-37. doi: 10.36660/abc.20190389.

Rawshani A, Franzén S, Eliasson B, Svensson AM, Miftaraj M, McGuire DK et al. Mortality and cardiovascular disease in type 1 and type 2 diabetes. New England Journal of Medicine. 2017 Apr; 376 (15): 1407-18. doi: 10.1056/NEJMoa1608664.

Rouberte ES, Araujo TL, Sousa DF, Nogueira DM, Maia RS, Moreira RP et al. Risco cardiovascular e fatores de risco cardiovascular em adolescentes. Revista Brasileira de Enfermagem. 2022 Mar; 75: e20210278. doi: 10.1590/0034-7167-2021-0278.

Dabelea D, Mayer-Davis EJ, Saydah S, Imperatore G, Linder B, Divers J et al. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. Journal of the American Medical Association. 2014 May; 311(17): 1778-86. doi: 10.1001/jama.2014.3201.

Guy J, Ogden L, Wadwa RP, Hamman RF, Mayer-Davis EJ, Liese AD et al. Lipid and lipoprotein profiles in youth with and without type 1 diabetes: the SEARCH for Diabetes in Youth case-control study. Diabetes Care. 2009 Mar; 32(3): 416-20. doi: 10.2337/dc08-1775.

Urbina EM, Isom S, Bell RA, Bowlby DA, D'Agostino Jr R, Daniels SR et al. Burden of cardiovascular risk factors over time and arterial stiffness in youth with type 1 diabetes mellitus: the SEARCH for diabetes in youth study. Journal of the American Heart Association. 2019 Jul; 8(13): e010150. doi: 10.1161/JAHA.118.010150.

Townson J, Lowes L, Robling M, Hood K, Gregory JW. Health professionals' perspectives on delivering home and hospital management at diagnosis for children with type 1 diabetes: A qualitative study from the Delivering Early Care in Diabetes Evaluation trial. Pediatric Diabetes. 2020 Aug; 21(5): 824-31. doi: 10.1111/pedi.13023.

Jaiswal M, Urbina EM, Wadwa RP, Talton JW, D'Agostino Jr RB, Hamman RF et al. Reduced heart rate variability is associated with increased arterial stiffness in youth with type 1 diabetes: the SEARCH CVD study. Diabetes Care. 2013 Aug; 36(8): 2351-8. doi: 10.2337/dc12-0923.

Rosengren A, Dikaiou P. Cardiovascular outcomes in type 1 and type 2 diabetes. Diabetologia. 2023 Mar; 66(3): 425-37. doi: 10.1007/s00125-022-05857-5.

Dart AB, Martens PJ, Rigatto C, Brownell MD, Dean HJ, Sellers EA. Earlier onset of complications in youth with type 2 diabetes. Diabetes Care. 2014 Feb; 37(2): 436-43. doi: 10.2337/dc13-0954.

Roberts AJ, Taplin CE, Isom S, Divers J, Saydah S, Jensen ET et al. Association between fear of hypoglycemia and physical activity in youth with type 1 diabetes: the SEARCH for diabetes in youth study. Pediatric Diabetes. 2020 Nov; 21(7): 1277-84. doi: 10.1111/pedi.13092.

Barola A, Tiwari P, Bhansali A, Grover S, Dayal D. Cross‐cultural adaptation and psychometric evaluation of Hindi version of Diabetes Self‐Management Profile‐Self Report in Indian type 1 diabetes patients. Pediatric Diabetes. 2021 Feb; 22(1): 101-11. doi: 10.1111/pedi.13071.

Larsson SC, Wallin A, Håkansson N, Stackelberg O, Bäck M, Wolk A. Type 1 and type 2 diabetes mellitus and incidence of seven cardiovascular diseases. International Journal of Cardiology. 2018 Jul; 262: 66-70. doi: 10.1016/j.ijcard.2018.03.099.

Shah AS, Black S, Wadwa RP, Schmiege SJ, Fino NF, Talton JW et al. Insulin sensitivity and arterial stiffness in youth with type 1 diabetes: the SEARCH CVD study. Journal of Diabetes and its Complications. 2015 May; 29(4): 512-6. doi: 10.1016/j.jdiacomp.2015.02.004.

Htay T, Soe K, Lopez-Perez A, Doan AH, Romagosa MA, Aung K. Mortality and cardiovascular disease in type 1 and type 2 diabetes. Current Cardiology Reports. 2019 Jun; 21(6): 45. doi:10.1007/s11886-019-1133-9.

Lee YB, Han K, Kim B, Lee SE, Jun JE, Ahn J et al. Risk of early mortality and cardiovascular disease in type 1 diabetes: a comparison with type 2 diabetes, a nationwide study. Cardiovascular Diabetology. 2019 Nov; 18(1): 157. doi: 10.1186/s12933-019-0953-7.

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Published

2025-07-31
CITATION
DOI: 10.54393/pjhs.v6i7.3183
Published: 2025-07-31

How to Cite

Shafiq, U., Munir, U., Naeem, M., Rehman, F. U., Ahmad, I., & Zafar, M. A. (2025). Comparative Cardiovascular Impact of Early-Onset Type 1 and Type 2 Diabetes and Associated Risk Factors in Pediatric and Adult Patients: Cardiovascular Impact of Diabetes . Pakistan Journal of Health Sciences, 6(7), 43–47. https://doi.org/10.54393/pjhs.v6i7.3183

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