Blood Sugar & Kids’ Heart Health | Protect Young Vessels

Behind the results is Ebba Bergdahl, newly awarded researcher at Sahlgrenska Academy and ST physician in emergency care at Sahlgrenska University Hospital Östra. In her thesis, she has studied how type 1 diabetes affects the cardiovascular system in children, and how this effect can change over time.

– We see that the impact on the heart and blood vessels can occur early in the course of the disease, already a relatively short time after diagnosis, even in children who are otherwise perceived as healthy, says Ebba Bergdahl.

New measurement methods and long-term follow-ups

The studies are based on clinical examinations of children aged 6–16 with follow-up after two years. Children with type 1 diabetes were compared with healthy controls.

– Type 1 diabetes is a disease that affects the entire body’s physiology. By following the children over time, we can see both how the body is affected and how it responds to changes in the treatment, says Ebba Bergdahl.

Using high-resolution ultrasound, which can visualize structures down to 30 micrometers, the researchers were able to study the structure of the blood vessels in detail, including in arteries in the wrist, foot and neck. The method makes it possible to differentiate between different layers in the vessel wall and detect changes that could not be seen before.

How the nervous system controls the heart was also investigated, as well as the children’s blood pressure during a whole day with so-called 24-hour measurement.

Hopeful results

The results show that children with type 1 diabetes may have early changes in blood vessels and in the nerve control of the heart. At the same time, the thesis shows something more hopeful than what has often been seen before.

In children with well-treated diabetes, for example with modern so-called hybrid closed-loop treatment where the insulin pump and glucose sensor partly work together automatically, improvements were seen in both blood pressure and the nerve regulation of the heart at follow-up. The improvements were linked to the children having more consistent blood sugar and spending more time within the recommended blood sugar range.

Previous studies have often been more disappointing, showing that cardiovascular effects gradually worsen in people with type 1 diabetes.

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– We are in the midst of a technological leap in diabetes treatment, where automated insulin pumps provide completely new opportunities to keep blood sugar stable. That is the most important explanation why we are now seeing such hopeful results. With good blood sugar control, some signs of heart and vascular damage can even improve over time, says Ebba Bergdahl.

Sweden at the forefront

In Gothenburg and in Sweden, care for children with type 1 diabetes is functioning well. The children have access to modern aids such as insulin pumps, glucose sensors and insulin, which provides good opportunities for careful follow-up and good blood sugar control.

Frida Dangardt, docent in clinical physiology at Sahlgrenska Academy, University of Gothenburg, and senior physician at Sahlgrenska University Hospital, was the main supervisor for the thesis work:

– These are clinically relevant results that show how important it is to work systematically with good blood sugar control already from the early phase of the disease. The fact that the studies have been published in journals with a wide international circulation can hopefully contribute to increasing the incentives in other countries to prioritize diabetes care for children, says Frida Dangardt.

The thesis was defended on Friday, December 12, 2025.
You can read the thesis here (ub.gu.se): Advanced phenotyoing of cardiovascular risk in children with chronic disease- Children with type 1 diabetes and kidney transplant recipients