Arterial hypertension in young patients with type 1 diabetes mellitus. Dysbiosis and increased paracellular intestinal permeability as potential links of pathogenesis

The incidence of type 1 diabetes is increasing worldwide, especially among young patients. This trend is very unfavorable, since the risk of death of diabetic patients from cardiovascular and other concomitant diseases is five times higher than that of patients without a history of type 1 diabetes. The main causes of premature mortality are micro- and macrovascular complications, aggravated by concomitant diseases, one of which is arterial hypertension. The risk of complications such as acute cerebral circulatory disorders, myocardial infarction, limb amputation, heart failure and sudden cardiac death increases with increasing duration and severity of hypertension, especially with its uncontrolled course. Patients with type 1 diabetes who are under inpatient or outpatient supervision and treatment, for the most part, do not control blood pressure, or are guided by data from home/office blood pressure measurements. In our opinion, it is worth paying special attention to screening diagnostics, early detection, as well as profiles of increased blood pressure in patients with type 1 diabetes, as this will allow us to consider the possibility of initiating antihypertensive treatment or optimizing therapeutic approaches to the management of this group of patients, and is also key to reducing the risk of adverse outcomes of this disease.

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