Impaired Endothelial Function in Adolescents with Type 1 Diabetes Mellitus

Objective: To evaluate the effect of a high-fat meal on endothelial function in adolescents with type 1 diabetes mellitus (T1D). Study design: Twenty-three children with T1D, aged 12 to 18 years, and age- and sex-matched healthy control subjects were assessed for baseline macronutrient intake, and endothelial function was measured both fasting and after a standardized fast-food, high-fat breakfast. Results: Endothelial function, assessed noninvasively by peripheral arterial tonometry, was impaired in the T1D group in the fasting state as compared with control subjects (T1D 1.78 ± 0.4, control subjects 2.06 ± 0.4, P = .02), and worsened postprandially in both groups (T1D 1.45 ± 0.3, control subjects 1.71 ± 0.3, P = .01). Both groups demonstrated significantly elevated triglyceride levels 3.5 hours after ingestion of the high-fat meal (T1D 114.8 ± 42.8 and control subjects 126.7 ± 54.9 mg/dL). Nutrient intake in both groups showed higher than recommended intakes of total fat, saturated fat, and cholesterol. Conclusions: Patients with T1D exhibited worse endothelial function both before and after a high-fat breakfast than their peers. This suggests that patients with T1D are at greater risk of vascular impairment after a high-fat meal, the cumulative effect of which may contribute to the higher atherosclerotic burden observed in T1D.