title: Retinopathy screening in patients with type 1 diabetes diagnosed in young age using a non-mydriatic digital stereoscopic retinal imaging.
abstract: BACKGROUND
  Diabetic retinopathy seriously impairs patients' quality of life, since it represents the first cause of blindness in industrialized countries.
  
  
  OBJECTIVE
  To estimate prevalence of retinopathy in young Type 1 diabetes patients using a non-mydriatic digital stereoscopic retinal imaging (NMDSRI), and to evaluate the impact of socio-demographic, clinical, and metabolic variables.
  
  
  METHODS
  In 247 young patients glycated hemoglobin (HbA1c), gender, age, pubertal stage, presence of diabetic ketoacidosis (DKA), HLA-DQ heterodimers of susceptibility for Type 1 diabetes, and β-cell autoimmunity at clinical onset were considered. At retinopathy screening, we evaluated age, disease duration, pubertal stage, body mass index (BMI-SDS), insulin requirement, HbA1c levels, other autoimmune diseases, diabetes-related complications, serum concentrations of cholesterol and triglycerides, systolic and diastolic blood pressure.
  
  
  RESULTS
  Retinopathy was found in 26/247 patients: 25 showed background retinopathy, and 1 had a sight-threatening retinopathy. A significant relationship between retinopathy and female gender (p=0.01), duration of disease ≥15 yr (p<0.0001), serum triglycerides levels >65 mg/dl (p=0.012) and mean HbA1c ≥7.5% or >9% (p=0.0014) were found at the multivariate logistic analysis.
  
  
  CONCLUSIONS
  Metabolic control is the most important modifiable factor and promotion of continuous educational process to reach a good metabolic control is a cornerstone to prevent microangiopathic complications. Symptoms appear when the complication is already established; a screening program with an early diagnosis is mandatory to prevent an irreversible damage.
authors: Pediatric Clinic, University of Genoa, IRCCS G. Gaslini Institute, Largo G. Gaslini 5, Genoa, Italy.
authors: N
authors: N
authors: Minuto
authors: V
authors: V
authors: Emmanuele
authors: M
authors: M
authors: Vannati
authors: C
authors: C
authors: Russo
authors: C
authors: C
authors: Rebora
authors: S
authors: S
authors: Panarello
authors: A
authors: A
authors: Pistorio
authors: R
authors: R
authors: Lorini
authors: G
authors: G
authors: d'Annunzio
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D003930:Diabetic Retinopathy / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009184:Mydriatics; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation; D055815:Young Adult
chemical_list: D009184:Mydriatics