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Speckle-tracking-derived 2D LV GLS is significantly impaired in youths with Type 1 DiabetesHeart Strain Imaging Shows Differences in Youth with Type 1 Diabetes

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Key Takeaway
Note that 2D LV GLS is significantly impaired in youth with Type 1 Diabetes, potentially aiding risk stratification.

This meta-analysis evaluates the use of speckle-tracking-derived Left Ventricular Global Longitudinal Strain (LV GLS) as a cardiovascular marker in youths with Type 1 Diabetes Mellitus (T1DM). The analysis included 1086 youths with T1DM and 935 controls for the 2D LV GLS analysis. The primary finding was that 2D LV GLS was significantly impaired in the T1DM group, with an effect size of -2.87% (95% CI -4.03 to -1.71).

In contrast, the analysis of 3D LV GLS showed no significant between-group differences. Meta-regression analyses for age, diabetes duration, and HbA1c reported no associations with the outcomes. The authors noted substantial heterogeneity (I = 96.2%) and characterized the current evidence as having low certainty.

Clinically, LV GLS may serve as a tool for cardiovascular risk stratification in this population. However, the low certainty of evidence and high heterogeneity suggest that these findings should be interpreted with caution when making clinical decisions regarding subclinical myocardial dysfunction.

How this fits prior evidence

This finding addresses a gap in cardiovascular risk assessment for pediatric populations with Type 1 Diabetes. While other evidence highlights the association between gut microbiota dysbiosis and T1DM pathophysiology, and notes that stem cell therapy shows only marginal, non-significant improvements in HbA1c, this meta-analysis provides a specific metric for myocardial strain. It complements the existing evidence that integrative therapies for Type 1 Diabetes are currently only preliminary.

Researchers looked at heart muscle function in 1,086 young people living with Type 1 Diabetes. They compared these results to a group of healthy individuals using a specific imaging technique called speckle-tracking. This method measures how the heart muscle contracts and moves over time.

The study found that the heart muscle movement, specifically measured as 2D LV GLS, was significantly impaired in the group with Type 1 Diabetes. However, other measurements, such as 3D LV GLS, did not show a significant difference between the two groups. Factors like the age of the patient, how long they had lived with diabetes, and their blood sugar levels did not change the results.

Because the evidence is currently of low certainty and the data was varied, these findings are not yet ready to change standard medical practice. However, this type of imaging could eventually help doctors better identify heart risks in young patients with Type 1 Diabetes. You should speak with a healthcare provider to discuss how these findings relate to your specific care.

What this means for you:
Heart imaging shows impaired muscle movement in youth with Type 1 Diabetes, which may help identify heart risks.

Common questions

What did the study find about heart health in children with Type 1 Diabetes?

The study found that a specific measurement of heart muscle movement, known as 2D LV GLS, was significantly impaired in youth with Type 1 Diabetes compared to healthy controls. This finding suggests that certain heart functions are affected by the condition, though the evidence is currently of low certainty.

Did factors like age or blood sugar levels affect the results?

The researchers performed a meta-regression to see if age, the duration of diabetes, or HbA1c levels influenced the results. They found no associations between these factors and the heart muscle measurements, meaning the impairment was observed regardless of those specific variables.

Is this finding enough to change how doctors treat Type 1 Diabetes?

The evidence is currently not strong enough to change standard medical practices. While the imaging tool could be useful for identifying heart risks in the future, patients should continue to follow their current treatment plans and talk to their doctors about new findings.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
AIMS: To assess Left Ventricular Global Longitudinal Strain (LV GLS) in youths with type 1 diabetes mellitus (T1DM) compared with healthy controls, as a marker of subclinical myocardial dysfunction. METHODS: We searched MEDLINE, the Cochrane Library, Scopus and the Web of Science up to November 2025 for studies comparing speckle-tracking-derived LV GLS in paediatric T1DM and healthy controls. Random-effects meta-analyses focused on two-dimensional LV GLS, with exploratory three-dimensional analyses, vendor-based subgroup analyses and meta-regression for age, diabetes duration and HbA1c. RESULTS: Twenty studies met the inclusion criteria. Eighteen studies (1086 youths with T1DM, 935 controls) were included in the primary 2D LV GLS analysis. Compared with controls, youth with T1DM had significantly impaired 2D LV GLS (mean difference -2.87%, 95% CI -4.03 to -1.71), with substantial heterogeneity (I = 96.2%). Exploratory 3D GLS analysis with three studies showed no significant between-group differences, and meta-regression revealed no associations with age, diabetes duration or HbA1c. CONCLUSION: Children and adolescents with T1DM show impaired left ventricular longitudinal deformation despite preserved conventional systolic indices, indicating early subclinical myocardial dysfunction. However, given the substantial heterogeneity and low certainty of current evidence, future standardized longitudinal studies are warranted. Ultimately, with the increasing use of speckle-tracking echocardiography, GLS may serve as a valuable tool for cardiovascular risk stratification in this population.
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