BLOOD PRESSURE PROFILE AND GLYCEMIC PROFILE IN TYPE 1 DIABETES MELLITUS
Background: The main objective of this study is to analyze the blood pressure profile of patients with type 1 diabetes mellitus and the aspect of the glycemic profile in order to identify the correlations between blood pressure and glycemia at a 24 hours’ monitoring interval, as well as the blood pressure modifications in the context of hypo and hyperglycemic episodes. Material and method: The study included 112 patients with type 1 diabetes mellitus, with disease duration of at least 10 years, from the Diabetes, Nutrition and Metabolic Disease Center Iasi and Suceava. The patients were evaluated both in terms of automatic blood pressure monitoring (ABPM) and continuous glucose monitoring system (CGMS) simultaneously for 24 hours. Results: The dynamic analysis of the glycemia during the day (active period) reveals an increase of the average values of the glycemia during the prandial period. At night, starting with 0.00 h, one may notice a progressive decrease of the average values of glycemia. In patients without arterial blood pressure, the blood pressure parameters are correlated, to a small extent, with the glycemia values. The risk of high blood pressure is 3.14 times bigger during the hypoglycemic period, in comparison with the normal glycemia period. The ongoing record of arterial blood pressure during hypoglycemia revealed high values for systolic, as well as for diastolic blood pressure, values considered significant from a statistical perspective (p <0.05). The risk of rise of the blood pressure values during the hyperglycemic period is 4.87 times bigger in comparison with the blood pressure values from the normal glycemia period. A slight, physiological decrease in arterial blood pressure (systolic blood pressure from 136.2 ± 21.2 mmHg to 132.3 ± 14.2 mmHg, p NS [not significant]; diastolic blood pressure from 87.3 ± 13.8 mmHg to 86.4 ± 12.6 mmHg, p NS) was observed in the group that showed a lower postprandial increase of blood glucose (<43.6 mg/dl). On the contrary, a significant postprandial increase of arterial blood pressure was observed (systolic blood pressure from 132.1 ± 17.7 mmHg to 148.6 ± 26.4 mmHg, p<0.05; diastolic blood pressure from 73.4 ± 14.3 mmHg to 82 ± 12 mmHg, p<0.05) in the group that showed a higher postprandial increase of blood glucose (>43.6 mg/dl). Conclusions: Hypoglycemia, but also postprandial hyperglycemia, a typical feature of type 1 diabetes mellitus, may increase the blood pressure values, causing higher hemodynamic stress. In type 1 diabetes mellitus patients, without high blood pressure, the blood pressure parameters are weakly correlated with the values of the glycemia.