الفهرس 
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Abstract
In this study, we aimed to investigate the reterobulbar blood circulation using Colour Doppler Imaging (CDI), also to investigate the possible alteration of intrarenal Doppler and to evaluate left ventricular dysfunction in type 1 diabetic children and adolescents who had no diabetic retinopathy (by fundoscopic examination), having normal renal function and no congenital heart lesions. Comparing these results with their healthy peers.
This study included:
3- One hundred children with type 1 diabetes without diabetic retinopathy (DR) were taken as a study group.
4- Forty healthy children were taken as a control group, they were age and sex mached.
Exclusion criteria:-
Diabetic children less than 2 years and more than 20 years, with duration of diabetes less than 6 months, last DKA less than 6 months, presence of retinopathy by fundus examination, nephropathy (abnormal renal function or hypertension), congenital or rheumatic heart disease, any medications known to affect the retinal, renal, or systemic circulation are the exclusion chriteriae.
Control subjects were chosen to have no regular medications and have no evidence of macrovascular, renal, or retinal vascular disease as well as diabetes or hypertension.
All children included in this study were subjected to clinical history taking, complete examination, blood pressure and fundus examination.
They are also subjected to laboratory investigation including fasting and post-prandial blood glucose levels, HBA1c, Micro-albuminuria, and renal function test.
All patients are subjected to renal Doppler, ophthalmic Doppler to evaluate the resistive index (RI) and echocardiography.
Our study showed that renal artery resistive index was significantly higher than that of controls, and it was correlated positively with the duration of diabetes, microalbuminuria and HbA1c. Ophthalmic artery RI was lower than that of controls and it was correlated negatively with duration of diabetes, microalbuminuria and HbA1c. Central retinal artery was higher than that of controls and it wasd correlated positively with duration of diabetes, microalbuminuria and HbA1c.
So, we can conclude that, renal and ocular Doppler RI evaluation could be useful to detect and monitor early changes of the renal and ophthalmic microvascular system in diabetic children, and contribute to the diagnosis of preclinical stage of diabetic nephropathy and retinopathy. There are significant changes of RI in the RA and OA occur in type 1 diabetic children and adolescents without nephropathy or retinopathy compared with healthy control subjects using Doppler Imaging. As duration of diabetes becomes longer, RI of RA and CRA increase and RI of OA decreases. These findings may be the first changes before vascular rigidity in the arterial circulation increases. These patients should be followed prospectively to confirm the factors that alter retinal hemodynamics and to determine the impact of changes in retinal hemodynamics in the development of DR.
Echocardiography had no value in early detection of diabetic complications.