Diabetes complication screening in 937 children and adolescents.
Results are presented of diabetes complication screening in children and adolescents aged 6-20 years. Their diabetes duration was 0.02-18.4 yr and median HbA1c over the preceding 36 months was 8.4% [IQR 7.8-9.3]. Gradable retinal photographs were obtained in 937: 110 less than 11 years (< 11 yr Gp). Albumin excretion rate (AER) was obtained from 3 timed overnight urine collections in 691: 100 in < 11 yr Gp. Early retinopathy was found in 27% (9% in < 11 yr Gp). Microalbuminuria (AER > or = 20 micrograms/min) was found in 4%. Significant individual risk factors for both complications were higher blood pressure, cholesterol, HbA1c, pubertal staging, older age and longer diabetes duration. Using multiple logistic regression, significant risk factors for retinopathy were longer duration and older age and in addition higher HbA1c. Diabetes complication screening detected early subclinical disease in children and adolescents who may benefit from lowering blood pressure and improving metabolic control. Screening should commence after five years of duration in young children, and after two years of duration in adolescents.
Ray Williams Institute of Paediatric Endocrinology, Diabetes and Metabolism, Royal Alexandra Hospital for Children, Westmead, NSW, Australia.
K C
KC
Donaghue
J M
JM
Fairchild
A
A
Chan
S J
SJ
Hing
N J
NJ
Howard
M
M
Silink
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000419:Albuminuria / Q000175:diagnosis / Q000209:etiology; D001794:Blood Pressure; D002648:Child; D002784:Cholesterol / Q000097:blood; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000209:etiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening; D016017:Odds Ratio; D009887:Ophthalmoscopy; D011379:Prognosis; D011627:Puberty; D012307:Risk Factors
D002784:Cholesterol; D006442:Glycated Hemoglobin