Evaluation of soluble CD40L in children with type 1 diabetes mellitus and its relation to diabetes associated vasculopathy

INTRODUCTION Type 1 diabetes mellitus (T1DM) is a dynamic autoimmune disorder characterized by retrogressive insulin production that is a consequence of autoimmune-mediated destruction of insulin producing pancreatic β-cells. Patients can be diagnosed with T1DM at any age, but the most common age of presentation is at early childhood years peaked at 5-7 years old. Patients with T1DM most often have lost approximately 80% to 90% of β-cell mass at the time of diagnosis, so they depend on exogenous insulin therapy for a steady blood glucose level. 4-6 With the impossibility to regenerate destructed beta-cells or cease the deterioration of T1DM at this late stage, the main target in management remains to supply adequate insulin and monitor for and prevent complications as much as possible. 7,8 Complications of T1DM have been defined as one of the foremost causes of morbidity and mortality worldwide. Such complications may occur as a result of microvasculopathy (i.e., retinopathy, nephropathy and/or neuropathy) or macrovasculopathy (i.e., cardiovascular disease, cerebrovascular accidents and/or peripheral vascular disease). In addition, children with T1DM display higher rates of disobedience to treatment, which make the situation more complicated. All of these considerations necessitate a competent, rapid and decisive method for early Original article