Background .– The relation between type 1 diabetes and cardiac structure and function in children is poor documented. We used 2D speckle strain imaging to investigate whether children and adolescents with type 1 diabetes have early echocardiographic signs of subclinical cardiac dysfunction and whether state of metabolic control and diabetes duration are of influence.

Methods .– Standard 2D echocardiography, mitral TDI and 2D speckle strain imaging were prospectively performed in type 1 diabetic children and compared healthy control subjects. Standard echocardiographic indices of global systolic and diastolic function, early peak diastolic mitral velocity (Ea), longitudinal strain (LS), radial strain (RS) and circumferential strain (CS) were investigated. A possible correlation was examined for HbA _1c and diabetes duration.

Results .– Overall 100 consecutive type 1 diabetic children (age: 11.3 ± 3.6 years, 52 boys, duration of diabetes ranged from 1.1 to 16 years) were compared to 79 control children. The diabetic and control children were comparable with respect to age, sex, heart rate, systolic, diastolic and mean blood pressure. Although obese patients were excluded, diabetic patients had significantly higher z -scores for BMI (0.32 ± 1.17 vs. −0.16 ± 0.73; P = 0.001). There were no significant differences between the two study groups with regard to LVEF, LV-EDD, IVS-EDD, LVPW-EDD, standard diastolic function parameters (A, E/A, and MDT) and TDI parameters. E-wave was significantly lower in the diabetic group (102.7 ± 16 vs. 108.4 ± 17.6 cm/s; P = 0.025). The LS was significantly lower in the group of diabetic children (−17.1 ± 1.7 vs. −20 ± 1.6; P < 0.001), while the circumferential strain and the radial strain did not differ. LS was positively correlated with HbA _1c ( r : 0.34; P < 0.01), while there was no correlation with the duration of the diabetes ( r = 0.12; P = 0.22).

Conclusion .– We demonstrated that left ventricular longitudinal myocardial deformation is decreased in young patients with uncomplicated type 1 diabetes. Metabolic control may be the main risk factor for these myocardial changes. This finding might be considered a very early preclinical alteration potentially related to subsequent development of diabetic cardiomyopathy.