Dilated Cardiomyopathy as the First Early Complication in a 14 Year-Old Girl with Diabetes Mellitus Type 1

Diabetic cardiomyopathy (DC) has been reported in type 2 diabetics with short duration of clinically overt diabetes, Impaired left ventricular function has been reported in young patients with diabetes mellitus type 1 (IDDM), but severe cardiomyopathy as the first early major complication of IDDM is very rare. We report a 14 year-old girl with a 5-year history of IDDM and very poor compliance with treatment and follow-up. She was referred to our clinic upon the development of congestive heart failure and dilated cardiomyopathy was diagnosed based on clinical findings, electrocardiogram, chest X-ray and echocardiography, She had no evidence of other major complications of IDDM such as retinopathy, nephropathy or neuropathy

Serum homocysteine concentration is related to diabetes mellitus, but not to coronary heart disease, in Saudi Arabians

Introduction: Plasma homocysteine (HCYS) concentration is believed to be an independent risk factor for atherosclerosis. Methods: HCYS was measured in a cohort of 584 Saudi Arabians participating in a national screening study of coronary heart disease (CHD) risk factors. A total of 173 subjects (114 men and 59 women) had clinical CHD, of whom 82 (47.4%) had type 2 diabetes mellitus (56 men and 26 women). A further 127 subjects (60 men and 67 women) also had type 2 diabetes mellitus but no CHD. A total of 284 individuals (120 men and 164 women) were recruited as healthy controls, and had no previous history of CHD or diabetes. Serum HCYS was measured by high-performance liquid chromatography (HPLC) with electrochemical detection. Results: Univariate analysis showed HCYS concentrations were significantly lower in those with diabetes mellitus (DM) than in controls, for both men [8.7 (4.2–18.6) vs. 10.5 (4.5–20.5) mmol/l, median (5th−95th percentiles, p = 0.009] and women [6.3 (3.3–24.0) vs. 8.1 (4.0–17.9) mmol/l, p = 0.049]. Stepwise multivariate regression analysis indicated a relationship between HCYS concentration and age, sex and the presence of DM, but not with CHD. Conclusions: In the Saudi Arabian population, serum HCYS is not a risk factor for CHD, but is lower in patients with DM