Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Clinical Senior Research Associate Loredana Marcovecchio, University of Cambridge, UK
- Second opponent: Professor Tine Willum Hansen, University of Copenhagen, Denmark
- Third member and chair of the evaluation committee: Professor Kjetil Retterstøl, University of Oslo
Chair of the Defence
Professor II Vegard Bruun Bratholm Wyller, University of Oslo
Principal Supervisor
Senior Consultant Hanna Dis Margeirsdottir, Oslo University Hospital
Summary
This thesis is conducted within the field of pediatric and adult endocrinology and addresses type 1 diabetes (T1D) and its long-term complications. The Atherosclerosis and Childhood Diabetes study is a prospective, population-based cohort study initiated in 2005, comprising children and adolescents aged 8–18 years, who are followed every 5 year. It was designed to improve the understanding of how atherosclerosis develops in individuals diagnosed with T1D during childhood.
The primary aim of this thesis was to examine subclinical atherosclerosis in young people with T1D, investigating longitudinal changes of inflammatory markers and carotid intima–media thickness (cIMT), alongside traditional cardiovascular risk factors. The hypothesis was that vascular complications begin earlier in childhood-onset T1D and are more extensive than previously thought.
At the ten-year follow-up (2017–2019), 201 individuals with T1D – approximately 24 years old and with 15 years of diabetes duration – and 97 diabetes-free controls were examined. Assessments included blood tests of glycemia, lipid levels, systemic inflammation, ultrasound measurements of cIMT, retinal examinations, and ambulatory blood pressure monitoring.
Individuals with T1D showed progressively higher levels of systemic inflammation, and young women with T1D demonstrated increased cIMT over time compared with age-matched female controls. Additionally, 27% presented with varying degrees of diabetic retinopathy, while 13% had undiagnosed hypertension.
In conclusion, this study demonstrates that vascular complications develop early and progress more rapidly over time in young individuals with childhood-onset T1D compared with diabetes-free controls, even among those with relatively short disease duration and without clinically apparent cardiovascular disease. These findings emphasize the importance of early and comprehensive cardiovascular risk assessment beyond glycemic control.
Additional information
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