I am a 20 year old female on a pump with type 1 diabetes since July of 1997. My last A1c was 9.3, which I am determined to improve. I have frequent pain in the right side of my chest, as well as in the center. At what age do cardiovascular complications start to appear? What are the symptoms a person will notice first? Also, what are the cardiovascular complications of diabetes? I am always very tired and I end up sleeping 11 hours a day on average, with trouble waking up. I often feel faint when I’m walking around. My blood pressure is 110/90, so this could not be the cause of my symptoms. I’m on no other medications other than Humalog. My appointment with a new endocrinologist is December 7th.

Your symptoms are not specific. They could be from poor glucose control. They could also occur from other disorders that can occur with type 1 diabetes. One of these conditions is adrenal insufficiency. Another is hypothyroidism. I am sure your endocrinologist will test you for these. As far as cardiovascular disease, there are new heart tests being performed to look at the heart. Patients with nephropathy are at highest risk from atheroscloerosis and heart attack. There is also the consideration of cardiomyopathy where the heart shows progressive deterioration in the ability to contract. I would talk to your physician about your symptoms. They may want to get an EKG. This is not a very sensitive marker for inducible heart disease because the heart is not being stressed enough to see an abnormality. What might be better is to actually undergo an exercise stress test. Reliance on symptoms alone is very difficult.

JTL