title: Prevalence of diabetes complications 6 years after diagnosis in an incident cohort of childhood diabetes.
abstract: OBJECTIVE
  To examine the prevalence of early diabetes complications 6 years after diagnosis of diabetes. The hypothesis that initial contact with a multidisciplinary team would be associated with a reduced risk of microvascular complications was tested in this cohort.
  
  
  METHODS
  Participants were recruited from an incident cohort of children aged < 15 years diagnosed between 1990 and 1992 in NSW, Australia. Initial management at a teaching hospital was documented at case notification. At 6 years, health care questionnaires and complications were assessed: retinopathy by 7-field stereoscopic retinal photography and elevated albumin excretion rate (AER) defined as the median of three overnight urine collections > or = 7.5 microg/min. Case attainment was 58% (209/361) with participants younger than non-participants and more likely living in an urban than rural location.
  
  
  RESULTS
  Retinopathy was present in 24%, median AER > or = 7.5 microg/min in 18%, and median AER > or = 20 microg/min in 2%. In multivariate analysis, initial management at a teaching hospital or consultation with all three allied health professionals combined with pubertal staging and cholesterol or HbA1c were all determinants of risk for retinopathy.
  
  
  CONCLUSIONS
  Early retinopathy and elevated AER are common in children 6 years after diagnosis. Initial allied health contact and management at a teaching hospital were associated with a reduced risk of microvascular complications in this cohort.
authors.affiliation: Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, NSW, Australia. kimd@chw.edu.au
authors.forename: K C
authors.initials: KC
authors.lastname: Donaghue
authors.forename: M E
authors.initials: ME
authors.lastname: Craig
authors.forename: A K F
authors.initials: AK
authors.lastname: Chan
authors.forename: J M
authors.initials: JM
authors.lastname: Fairchild
authors.forename: J M
authors.initials: JM
authors.lastname: Cusumano
authors.forename: C F
authors.initials: CF
authors.lastname: Verge
authors.forename: P A
authors.initials: PA
authors.lastname: Crock
authors.forename: S J
authors.initials: SJ
authors.lastname: Hing
authors.forename: N J
authors.initials: NJ
authors.lastname: Howard
authors.forename: M
authors.initials: M
authors.lastname: Silink
mesh_terms: D000293:Adolescent; D000419:Albuminuria / Q000453:epidemiology / Q000652:urine; D002648:Child; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000517:prevention & control*; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D015438:Health Behavior; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires