الفهرس 
Introduction
Chapter I :Type 1 diabetes mellitusOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus is associated with long-term damage, dysfunction and failure of various organs especially the eyes, kidneys, heart and blood vessels.
Although published work on diabetes and the heart relates mainly to type 2 diabetes, type 1 diabetes also imparts substantial risk for cardiovascular disease. Abnormalities of LV function primarily reflected a diastolic abnormality which was an early sign of diabetic cardiomyopathy, and had been shown to precede systolic dysfunction in diabetic patients.
Echocardiography can be used for the diagnosis of diabetic cardiomyopathy or diabetes-induced myocardial dysfunction. Moreover, tissue Doppler imaging (TDI) had emerged as a new sensitive technique for the evaluation of diastolic function.
The aim of the work was to detect early left ventricular dysfunctions in children with type 1 diabetes mellitus and their correlation with the glycemic control of these children.
our study included two groups, (Group Ι) included 46 children who were diagnosed as type 1 diabetic patients, and (Group II) which included 23 apparently healthy, age and sex matched children as a control group.
The studied groups were subjected to thorough history taking, clinical examination, laboratory investigations including total serum cholesterol and triglycerides also; their left ventricular functions were assessed by resting Trans Thoracic Echocardiography (TTE) and Tissue Doppler Imaging (TDI).
As regard the results of the current study, we found significant higher diastolic indices by both TTE and TDI in type 1 diabetic children than the control group. Indicated by significant higher E and A waves’ velocity values by TTE, significant higher septal Am, lateral Em, Am velocities by TDI and significant higher septal and lateral E/ Em ratios. On the other hand, there was insignificant difference between the type 1 diabetic children and the control groups as regard the systolic function indicated by EF%.
Diagnosis of definite left ventricular diastolic dysfunction was detected in 5 (10.9%) diabetic children by TTE and in 7(15%) diabetic children by TDI. This diastolic dysfunction suggested to be caused by increased LV diastolic stiffness, deposition of advanced glycation end products, and cardiac fibrosis, all as a consequence of diabetes mellitus.
Moreover, there were significant fair negative associations between age and triglycerides levels with E∕ A ratios. Also, insulin dose had a significant fair negative correlation with EF%, while, cholesterol and triglycerides levels had significant fair positive correlations with EF% (systolic function by echocardiography).
Finally, there were insignificant associations between duration of the disease, hypoglycemic attacks, DKA, systolic and diastolic blood pressures, HbA1c% levels and different echocardiographic, tissue Doppler parameters.