Microalbuminuria and Heart Rate Variability in Adolescents With Diabetes

• Published in: Journal of pediatric health care Vol. 24; no. 1; pp. 34 - 41
• Main Authors: Faulkner, Melissa Spezia, DSN, RN, FAAN, Quinn, Lauretta, PhD, RN, CDE, Fritschi, Cynthia, PhD, RN, CDE
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.01.2010
• Subjects: Adolescent; adolescents; Advanced Practice Nursing; Albuminuria - diagnosis; Albuminuria - etiology; Albuminuria - metabolism; Albuminuria - prevention & control; Arrhythmias, Cardiac - diagnosis; Arrhythmias, Cardiac - etiology; Arrhythmias, Cardiac - prevention & control; complications; Creatinine - blood; Cross-Sectional Studies; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - metabolism; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - metabolism; Diabetes-type 1; diabetes-type 2; Electrocardiography, Ambulatory; Female; Glycated Hemoglobin A; Humans; Hypertension - etiology; Hypertriglyceridemia - etiology; Male; Mass Screening; Nurse Practitioners; Nursing; Nursing Assessment; Obesity - etiology; Pediatric Nursing; Pediatrics; Risk Assessment; Risk Factors; Statistics, Nonparametric; Diabetes-type 1; diabetes-type 2; complications; adolescents
• ISSN: 0891-5245; 1532-656X
• DOI: 10.1016/j.pedhc.2009.01.002

Abstract Introduction Limited clinical and research data are available on early renal and cardiovascular complications in youth with diabetes. The possible associations of elevated microalbuminuria to creatinine (MC) ratios with heart rate variability (HRV) were explored in adolescents with type 1 (T1DM) or type 2 (T2DM) diabetes. Methods A descriptive study was conducted with 41 adolescents with diabetes (n = 31 T1DM vs. n = 10 T2DM). Twenty-four hour Holter recordings for determining HRV, urine spot checks for MC ratio, and the most recent measures of glycosylated hemoglobin (A1c) were obtained. Results HRV was significantly lower in the T2DM group, while body mass index percentile, triglycerides, and diastolic blood pressure were significantly higher. For the T1DM group, clinical case examples provided evidence of elevated MC ratios (>30μg/mg) occurring in two female subjects who also had decreased HRV measures. Discussion Although HRV was not significantly associated with MC ratios for the sample, individual clinical findings can be a warning sign for some adolescents with diabetes. Current recommendations for screening of early renal complications and associated treatment are provided.